ASQ Ordering Guide ORDER FORM Stock # Qty Title Questionnaires, Online System, Training DVDs, and more Questionnaires, Online System, Training DVDs, and more Price ASQWEB- __ __ __ __ __ ASQWEB- __ __ __ __ __ ASQWEB- __ __ __ __ __ ASQWEB- __ __ __ __ __ ASQ Discounts Buy 6 or more copies of the same ASQ family product and SAVE: 6-10 copies: 5% 11-20 copies: 10% 21-50 copies: 15% 51-100 copies: 20% 101-200 copies: 25% 201-500 copies: 30% 501-1000 copies: 35% 1001-2500 copies: 40% 2501+ copies: 45% Product subtotal (in U.S. dollars) Shipping (see chart at bottom) Order subtotal PA, WA, TX, IN, & MD state sales tax or GST (for CAN residents)* (Please note: the ASQ-3TM Materials Kit has a discount limit of 35%. ASQ Pro, ASQ Enterprise, and ASQ Family Access are not discounted.) Grand total Convenient ways to order: CALL toll-free 1-800-638-3775 M-F, 9 a.m. to 6 p.m. ET. FAX 410-337-8539 ONLINE www.brookespublishing.com MAIL order form to: Brookes Publishing Co. P.O. Box 10624 Baltimore, MD 21285-0624 Money-back guarantee! Ordering with Brookes is risk-free! If you are not completely satisfied, you may return products within 30 days for a full credit of the purchase price (unless otherwise indicated). Refunds will be issued for prepaid orders. Items must be returned in unused and resalable condition. Policies and prices subject to change without notice. Prices may be higher outside the U.S. o Check enclosed (payable to Brookes Publishing Co.) o Purchase Order attached (bill my institution—P.O. MUST be attached) Shipping & Handling (For other shipping options and rates, call 1-800-638-3775, in the U.S.A. and Canada, and 410-337-9580, worldwide.) *We reserve the right to add an additional 2% order processing fee on all orders that require special processing. o Continental U.S.A.; U.S.A. territories & protectorates; AK, HI & PR‡ Please charge my credit card: o American Express o MasterCard o Visa o Discover Credit Card # _____________________________________________________________________________ Exp. Date: _________ Security code (3 digit code on back of card, or 4 digit code on front of card for American Express): __ __ __ __ Signature (required with credit card use): _______________________________________________________________________ Name: ______________________________________________________________________________________________________ Daytime Phone: _____________________________________________________________________________________________ Organization:________________________________________________________________________________________________ Street Address: ______________________________________________________________________________________________ Complete street address required. o residential o commercial City/State/Zip: ___________________________________________________________________ Country: ___________________ o Yes! I want to receive the ASQ News & Updates e-newsletter! My e-mail will not be shared with any other party. Write in your title and check area of specialty: ____________________________________________________________________ o K–12 o 4-year College/Graduate o Community College/Vocational oClinical/Medical Add* US$50.00 and under $6.50 US$50.01 and over 13% ‡ AK, HI, and PR please add an additional US$12.00. Orders ship via UPS Air. Please call or email for expedited shipping options and rates. Canada For subtotal of Add* US$70.00 and under $10.50 US$70.01 and over 15% Orders for Canada are consolidated for shipping twice each month. For minimum shipping time, please place your orders by the 9th or 24th of each month. *calculate percentage on subtotal *PA,WA, TX, IN & MD residents: Please add state sales tax. ABOUT YOU o Birth to Five For subtotal of Canadian residents: please add your GST. Sales tax should be calculated based on the total order (including shipping) in U.S. dollars. If sales tax is calculated incorrectly, Customer Service will correct it prior to processing your order and the adjusted total will appear on your invoice. o Community Services 1-800-638-3775 1-800-638-3775 o Association/Foundation YOUR LIST CODE IS ASQWEB 2/15 www.agesandstages.com www.agesandstages.com A product of A product of