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Print out and mail (or fax) this form and payment to the address below.

Please send me the following products:

Books:
_____ A Bird's-Eye View of Life with ADHD and EFD ...Ten Years Later
3rd Edition @ 19.95
__________
_____Teaching Teens with ADD, ADHD, and Executive Function Deficits
2nd Edition @ 24.95
__________
_____Teenagers with ADD & ADHD, 2nd edition @ 24.95__________
Videos:
_____ Real Life ADHD! A DVD survival guide for children and teens (DVD) @ $34.95 __________
_____ Father to Father: Expert advice on ADHD (DVD) @ $25.00 __________
_____ Teen to Teen: the ADD Experience (VHS) @ $28.00 __________
_____ Teen to Teen: the ADD Experience (Spanish) (VHS) @ $28.00 __________
Poster:
_____ ADD/ADHD Iceberg poster (color 11x17) @ $6.00 __________
 
Shipping and handling: Add 10 % ($5.00 minimum)
__________
Call for FED EX 2 day delivery rates
 
TOTAL ENCLOSED:__________

Ordered by:

Name: __________________________________________________________

Organization: ____________________________________________________

Street: __________________________________________________________

City: ___________________________State: _______Zip Code: ___________

Phone #: ______________________ e-mail address: _____________________

Please autograph my book for: _________________________ (child, school, agency, doctor, etc)

To order:
Call or fax: 256-779-5203 or
Mail checks to:
      Chris A. Zeigler Dendy Consulting LLC
      PO Box 189
      Cedar Bluff, AL 35959