KCK Publishing Order Form


Ordering Address:

Name: _________________________________________

School Name: ___________________________________

Address: ________________________________________

City: __________________   State: _______  Zip Code: ____________

Telephone Number: ______________________________

E-Mail Address: _________________________________ (Optional) 

The current pricing structure is $100.00 for a single copy. If a school system wishes 
to purchase additional copies, the price is $100 for the first copy and $20.00 each 
additional. There is a discount for volume orders. Please call, write, or E-mail for 
details. At this time, we can only accept checks or money orders.

I Can Do This! I.S.B.N. #0-9700658-0-9


Quantity :_________                              $100


Additional Copies at $20 Quantity :_________     $_______________

Shipping                                         $5

Total:                                           $_______________

KCK PUBLISHING
127 TOAS ST • SHELTON, CT • 06484
PHONE: (203) 913-1389/924-1147
E-MAIL: KCKPUB@KCKPUBLISHING.COM