Fit For Your Life Order Form
P.O. Box 396
   Brookline, MA 02446-0003

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 Please fill out this form on your computer, then print and mail it to us with your check or money order.

 Name:   Title:

 Organization:    Phone:

 Street:    

 City: State:    Zip:

 Email Address:
 

    
 Item/Order Number

Qty

Unit Cost

Qty Discount,
if Applicable

 Total
 10010 Fit For Your Life Training Manual
  $50.00 $ $
 10011 Get Ready to Exercise Guide 15.00 $ $
 10012 Exercise Intensity Scale $ 4.00 each
           10% discount on orders of 10 or more		  $4.00 $ $
 10013 Exercise Prescription Pad
          10% discount on orders of 10 or more		  $5.00 $ $

  10014 T-Shirt (specify size)    		 $15.00 $ $

  10015 Leadership Package
  Add T-Shirt $10                       		 $65.00 $ $
  Sub Total
$
Postage and Handling   Orders under $10 add $2
                                                          $11 - 20 add $5
                                                          $21 - 50 add $10
                                                          $51 - 100 add $15
                                                          Orders over $100 – please contact us 		Postage and Handling
$
  Check enclosed
  Purchase order enclosed #

 Please include a check (payable to the
 Fit For your Life Foundation) or Purchase Order
 with your order and send to:

   Fit for Your Life Materials
   P.O. Box 396                                              Please allow three weeks for delivery
   Brookline, MA 02446-0003
 Total Order
$