Order Form

	Wisconsin CCR&R Network, Inc. "Making Child Care Work"	Order Form

Order Form

Fill in the form below and fax it to 608-271-1268 or mail with your payment to:

Wisconsin CCR&R Network

5 Odana Court

Madison, WI 53719

Please make checks payable to "Wisconsin CCR&R Network" and allow 2-3 weeks for delivery.

First Name: Last Name:

Agency Name:

Street Address:

City: State: Zip Code:

Mailing Address (if different from above):

City: State: Zip Code:

Phone: e-mail:

Brochures (Enter the quantity you would like to receive.):

Your Guide to Legal Child Care (brochure available in Spanish below)

Su Guia Para El Cuidado Para Ninos Legal

Your Guide to Licensed Child Care (brochure available in Spanish below)

Su Guia Para El Cuidado Para Ninos Bajo Licencia

Your Guide to Choosing Child Care (brochure available in Spanish below)

Su Guia Con Respeto Al Escoger Cuidado Para Ninos

Posters:

Explore Quality Child Care Choices (English)

Investigue Las Alternativas Para El Cuidado de Ninos de Calidad (Spanish)

Videos and Books:

Quantity	Description	Price	Amount Due:
	"Exploring Quality Child Care Choices" 12 minute video	$10.00 per video	$
	"Paj Ntaub (Flower Cloth)" Family Child Care: Important Work for Your Community 12 minute video SORRY--NO LONGER AVAILABLE		$
	"Child Care Options for Employers" 74 page manual	$10.00 per manual	$
		Total Due:	$