Web Order Form
Please submit this form once for EACH book ordered

™ If you are paying through PayPal
  • If you are paying through PayPal, please proceed to check-out and PayPal will redirect you back to this page.
  • If you are mailing a check to Brighter Learning or would like us to email you a PayPal Invoice, you may submit this form and then mail in a check (If you would like Brighter Learning to total your order, check the appropriate box toward the bottom of this form).

 Purchaser Name         Purchaser Email or Phone  

  • Please type in either the location of the brochure/order form you received or the 8 digit number from the top left column of the order form.

    •  Brochure Location or Number   

    BOOK LANGUAGE and TITLE (Language the text will be written in and the title of the selected book).

    English Text / Title   

      Spanish Text / Title 

    • First Name:    Middle Name (Optional): 
    • Nickname (Optional: after 1st page, program uses nickname throughout book):
    • Last Name: 
    • Gender:  Female     Male                                  Age (optional): 

    • Hometown and State (ex., Woodland Park, Colorado): 

    • Three Friends, Relatives, Pets, etc. that you want listed in the story (maximum combined length including commas and spaces is 55).
    • Message (ex, With Love! or Happy Birthday): 
    • This Book is From: 
    • Date (optional: ex May 2008 or May 15, 2008): 

    If you are ordering My Baby Book, Football Star, G-o-o-oal, or School is Fun,

    please continue below in the appropriate area.

     

    Additional Information for My Baby Book ONLY

     

    VERSION:  Two-Parent        Mother Only      Father Only

    • Date of Birth:   Month       Day     Year 

    • Time of Birth:       AM    PM

    • Baby's Weight:  Pounds    Ounces 

    • Baby's Length (Inches): 

    • Delivered By:     Hospital: 

    • Mom's First Name (If Applicable):   

    • Father's First Name (If Applicable):

    Additional Information for Football Star / G-o-o-oal Soccer (optional)

    • Favorite Players: 

    • Winning Team:    Losing Team:

    Additional Information for School is Fun ONLY (optional)

     

    • Teacher's Name:    School Name:

    PAYMENT:    PayPal – Please send PayPal Invoice – PayPal account not required

         PayPal – Using Shopping Cart

         Mailing Check/Money Order

               (Brighter Learning, 181 Honey Hill Ln, Woodland Park, CO  80863)

                  Check if you would like your total e-mailed to you.

         Redeeming Gift Certificate:   Amount     Code 

    Would you like to be on our Mailing List?    Yes  How would you like to receive Specials 

                                                                             No     Already on List

    • Information is NEVER sold, traded or given to another party.

    SHIPPING ADDRESS:

                                          

     

    Comments:

                        

     

    PLEASE VERIFY ALL INFORMATION ON FORM BEFORE SUBMITTING.

    • If Customer makes a mistake, we will reprint at a Lesser Cost.

    • Satisfaction Guaranteed - Full Refund less S/H if returned within 30 days.

    • FREE Photo Frame Sticker with each Book Purchase.

                


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