Order Form (Please complete this section) Date Name Surname Physical address for delivery Who will accept delivery of the programme materials? (provide the full name, if this is different to the name above). Please select the items you would like to purchase: Quantity: Amount: MEDIATOR’S MANUAL COGNITIVE TOOL KIT & PICTURE SETS MEDIATOR’S MANUAL & TOOL KIT+ PICTURE SETS (FULL PROGRAMME) Total Please indicate your postal preference: DHL Courier Service (2-4 days) Airmail (15 working days) DHL Courier Service Airmail When do you intend to make the purchase: Email: Skype Name: Telephone: Cell/Mobile: Please submit the numbers above before proceeding. "Spam Filter"
Order Form (Please complete this section) Date
Name Surname Physical address for delivery Who will accept delivery of the programme materials? (provide the full name, if this is different to the name above). Please select the items you would like to purchase:
Please indicate your postal preference: DHL Courier Service (2-4 days) Airmail (15 working days) DHL Courier Service Airmail When do you intend to make the purchase: Email: Skype Name: Telephone: Cell/Mobile: Please submit the numbers above before proceeding. "Spam Filter"
