Asperger's Association of New England	85 Main Street, Suite 101 Watertown, MA 02472 Phone: (617) 393-3824 Fax: (617) 393-3827 Email: info@aane.org

AANE Publication Order Form

Print out this form, complete and send with check or money order to:
AANE, 85 Main Street, Suite 101, Watertown, MA 02472

Disclosure (paper book)	$7.50 *	# copies: _____
Journey through Life DVD	$17.50 **	# copies: _____
Celebration of Women DVD	$17.50 **	# copies: _____
Total Payment:

* includes shipping
** includes shipping in USA

Ship to:

Name:
Address:
Town:		State:		Zip:

Contact via phone or email:

Will pay by:   ____Check   ____MC   ____Visa   ____AMEX

Name as it appears on card (if different from above):
Billing Address (if different from above):
Credit Card Number:
Expiration Date:

AANE tax ID # 04-3376227