Washington State Dairy Council Materials Catalog 2014 | Page 5

WASHINGTON STATE DAIRY COUNCIL ORDER DEPARTMENT HOURS - 8:30 AM - 4:00 PM NOTE: IF FAXING AN ORDER - PLEASE DO NOT MAIL IT Allotment orders received after December 14, 2014 will be applied to 2015 allotment. Warehouse closed Dec. 15, 2014 - Jan. 2, 2015. Please photocopy for multiple use. DOWNLOAD ORDER FORM: www.EatSmart.org>Materials Catalog SHIP TO: Orders with BALANCE DUE must be prepaid unless accompanied by a purchase order number. Type or print complete shipping information DATE FULL NAME: QUALIFIED TITLE: (First & Last) (SEE BELOW) COUNTY: SCHOOL DISTRICT: SCHOOL/BUSINESS NAME: STREET ADDRESS:* POST OFFICE BOX:* DAY PHONE: ( CITY:* ) STATE:* ZIP:* EMAIL: COMPLIMENTARY $20.00 ALLOTMENT One per calendar year, per qualified person, WA and AK residents only Sign me up for your online newsletter! Please print clearly the FIRST and LAST NAME and TITLE of Allotment User(s). (Orders Will Not Be Shipped If Allotment Has Already Been Used For 2014 Calendar Year.) Name Title QUALIFIED TITLES: • PE/Health Educators • K-12 Teachers • School Nurses • Food Service Directors or Managers • WIC and Public Health Nutrition Educators • Physicians, Dietitians and Nutritionists • Worksite Wellness Coordinators • Nurses • WSU & UAF Extension Professionals ALLOTMENT ORDERS RECEIVED AFTER DECEMBER 14, 2014 WILL BE APPLIED TO 2015 ALLOTMENT. WAREHOUSE CLOSED DEC. 15, 2014 - JAN. 2, 2015. SHIPPING AND TAX CHARGES DO NOT APPLY TO INDIVIDUAL ALLOTMENT ORDERS OF $20.00 OR LESS CHECK OR MONEY ORDER payable to W.D.C. Include with order CHECK # CREDIT CARD PURCHASE Please print name clearly CHECK ONE: MASTERCARD VISA AMERICAN EXPRESS* Cardholder Signature W ashington State DAI RY COUNCIL The Nutrition Education People 3 DIGIT VERIFICATION: ACCOUNT NUMBER: 4201 - 198th St. SW Lynnwood, WA 98036-6751 Phone: [phone] Fax: [phone] Toll Free Fax: [phone] Email: [email protected] THA FOR YNKS ORDEOUR R! EXPIRATION DATE: *American Express 4 digit PURCHASE ORDER # MONTH YEAR ORDER ONLINE AT www.EatSmart.org (ALLOTMENT ORDERS NOT ACCEPTED ONLINE) Download order form to email, fax or mail Check out our “FREE RESOURCES” online WASHINGTON STATE DAIRY COUNCIL 2