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Please Print this Form and Send/Fax Prepaid Orders to:

National Catholic Partnership on Disability

The McCormick Pavilion

415 Michigan Ave., NE, Suite 240

Washington, DC 20017

(202) 529-2933 • (202) 529-4678 fax • (202) 529-2934 tty

Or Email non-prepaid orders to: ncpd@ncpd.org

QTY	ITEM	UNIT PRICE	AMOUNT




	Subtotal
	Shipping & Handling
	Admin. Fee on Orders NOT PREPAID	5.00
	Make Checks Payable to NCPD	Total

SHIPPING & HANDLING

Orders up to $9.99……………………….$5.75

From $10.00 - $19.99……………………..6.25

From $20.00 - $29.99……………………..7.00

From $30.00 - $49.99……………………..8.50

From $50.00 - $99.99………….…...……13.50

From $100.00 - $500.00…………………..20%

Over $500.01……………………………….15%

Name:_____________________________________________________________________________

Organization: ___________________________________________________________________

street Address_________________________________________________________________

City:___________________________________________State:______Zip:__________________

Telephone:______________________________________Fax____________________________

E-mail:___________________________________________________________________________

ITEM