CURRICULUM MATERIALS ORDER FORM

PASSPORT TO THE UNIVERSE
Instructional Materials for School or Home

Video: (2 one-hour videos)
$29.95 each

NOTE: INTERNATIONAL SHIPPING CHARGES WILL BE ADDED TO ALL ORDERS. OVERSEAS PAYMENT SHOULD BE MADE IN U.S. DOLLARS

Ordering Information:
Print and complete all information below.
All prices are for US denominations.
Shipping is included for orders shipped to US addresses only.
Shipping fees for international orders will be on a case by case basis.

Send To:
PASSPORT TO KNOWLEDGE
27 Washington Valley Road
Morristown, NJ 07960

Fax to: 973.656.9813

_______________________________________________________
Name:

_______________________________________________________
School (or home) address:

_______________________________________________________
Mail to address (if different from above):

_______________________________________________________
Daytime contact phone number:

_______________________________________________________
E-mail:

Videos:
_____ PTUNIVERSE Program 1 "Live from a Black Hole" @ $29.95 each ____ Total
_____ PTUNIVERSE Program 2 "Live from the Edge of Space and Time" @ $29.95 each ____ Total

Shipping is included!

Credit card# /_____________/______________/________________/_________________

Mastercard [  ] Visa [  ] Expires:__________________

Print and complete form then fax to 973.656.9813, or mail to:
PASSPORT TO KNOWLEDGE
27 Washington Valley Road
Morristown, NJ 07960

Thank you for your interest in Passport to the Universe! If you have any questions, please call 973.656.9403 or e-mail ptkinfo@passporttoknowledge.com