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ORDERING OPTIONS
ORDER FORM Mail, phone or website

Name: ____________________________________ Business Name: ________________________________
Address: ________________________________________________________________________________

City: ____________________________________________ State: ____________Zip:___________________
Daytime Phone: ___________________________ Email Address: __________________________________
PO Box (if applicable): _______________________
Check here to receive exclusive offers from CAC via email Prices subject to change.
Curriculum How many Choose one of the following options:
children?
1 Month: 3 Months: 6 Months: 9 Months:
School Year Number For the month Starting Month: Starting Month: Starting Month:
of
Curriculum runs of: ____________ ____________ September
children Ending Month: Ending Month:
September-May ____________ ____________ Ending Month:
May
Jumping Kangaroo
Tiny Tots
Son Shine

Little Disciples
Summer: Jumping Kangaroo
Summer: Tiny Tots

Description Quantity Product Price Total Price

Automatic Charge Program- (Check here if you would like
your card automatically charged on the 10th of each
month.) You may cancel anytime or make changes to your Order Totals
order as your needs change. Please contact us before the
5th of the month for any updates or cancellations. Total Curriculum Price
Extra Instructional Guide: $3.00 each
Payment Information

Additional Products
Visa, MasterCard, Discover and American Express
Curriculum Shipping
Card Number:
Products Shipping (with Curriculum):
Products Shipping (without Curriculum):
Expiration Date: CVV:
MN Customers add State Sales Tax 6.875%:

Signature: Total
Need help placing your order?
Call 1-877-746-8128 Monday-Friday 8:00-4:30 CST