PART I

CONTACT INFORMATION

Name:     

Address: 

City:             State:        Zip: 

Email:            Tel:  

PART II

ORDER SECTION

(If you would like to order one of our products, complete the following items, print out a copy of this page for your records, then click submit at bottom of page:)

                                                                                                   QUANTITY

The Adventures of GB Coloring Book (Part 1)  $3.00 each                       

 The Adventures of GB Soundtrack       $10.00                                           

The Adventures of GB Story Book (Level 5+),  $10.00 each                     

Shipping: $2.00 each item                                                                               

Grand Total                                                                                                     

When finished, print 2 copies of this page then CLICK the SUBMIT button at bottom of page and mail your check or money order with copy of this page to:

PART III

EVENT BOOKING

(Complete this section in addition to Part I above only if you are interested in booking Diane Lockett for a future Book Signing, Speaking Engagement or Edutainment Performance by Big Mama. Include your preferences in the Comment Section)

Event Name: 

Date of Event: 

Event Location: 

Approximate Number of Attendees Expected: 

Name of Sponsoring Organization:

Contact Information / Comments: