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ADD Focus, Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder

Fax/Mail Order Form

Print, fill out, and mail or fax your order.

Order By Mail
ADD Focus
1442 E Lincoln Ave, Suite 131
Orange, CA 92865
Customer Service:  714-665-2508
Order By Fax
(714) 921-4762
Quantity Product/Price Quantity Product/Price
  Anger Control (Audio Tape)/$12.98   Memory Power  (Audio Tape)/ $12.98
  Being A Happy Parent (Audio Tape)/ $12.98   No One To play With (Book)/$14.00
  Building Your Child's Self-Esteem (Video Tape)/$39.95   Phonics Game (Learning System)/ $199.95
  Caps, Commas and Other Things (Book)/   $18.00   Phonics Game (Learning System - With CD ROM)/ $249.90
  Concentration (Audio Tape)/$12.98   Phonics Game (Learning System - With CD ROM & Phonics Readers)/ $284.85
  Cues and Comprehension (Reading)
(4 Books)/$48.00
  Phonics Remedial Reading Lessons (Workbook)/$17.00
  Cursive Tracking (Book)/$10.00   Progressive Relaxation & Breathing (Audio Tape)/$11.95
  Effective Studying (Audio Tape)/$12.98   Remediation of Reversals (Workbook)/ $27.00
  Focus (Learning System)/$49.95
  Self-Image For Children (Audio Tape)/ $12.98
  Focus (Nutritional Supplements - 90 Tabs)/$34.95   Songs For Self Esteem   (Audio Tape)/ $10.95
  Hypnosis For Improved Learning   (Audio Tape)/$11.95   SOS For Parents (Book)/$12.95
  Junior Phonics (Learning System)/ $159.95    Successful Teens (Audio Tape)/$12.98
  Kid Cooperation (Book)/$12.95   Tuned-In Turned-On Book About Learning Disabilities (Workbook)/ $12.00
  Learning Power  (Audio Tape)/ $12.98   Why Children Misbehave (Book)/$14.95
  Math Game (Learning System)/$219.95    
Total Cost of Products $________________
*Add 10% (Minimum of $3.00) For Shipping & Handling $________________
Subtotal $________________
California Residents Add 7.25% (Orange County 7.75%) Sales Tax $________________
Total Amount $________________
[] Enclosed please find a check in the amount of $________ (US Funds) equal to the total amount above.
[] Please charge the amount of $________ (US Funds) equal to the total amount above to my credit card:
[] AMEX  [] Discover  [] MasterCard   [] Visa Number _____________________________  Exp ___/___

Name on Card ___________________________________

Signature ______________________________________

Ship To:   Name __________________________________________________________________
Address __________________________________________________________________
City ________________________ State/Prov_______ Zip _____ Country ________
Telephone (____)_______________  EMail _________________________________

*  Please add 15% (minimum of $5.00) for shipping & handling for all orders to be shipped OUTSIDE the USA.

(Please allow 7 to 14  days for arrival)

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