Asperger's Syndrome Institute®

Printable Order Form

This form allows you to create an order form which you can print and submit with your check or money order by mail to order our products.

How to order:
  1. Select the item(s) you are purchasing (one item per row)
  2. Enter the quantity for each item and your total will be computed for you
  3. Complete your shipping and billing addresses
  4. Print and mail with check or money order OR FAX to: 717-259-6061 (Fax only number)
  5. For FAX orders, write your credit card info on the form before faxing

Checks or money orders are preferred.

Please send checks made to:

Rosalind Hoffman
A.S.I.
P.O. Box 113
Dillsburg, PA. 17019

Allow one to two weeks for delivery.

Please email us to inquire about P.O.s. or telephone orders: Please note: ordering through our Institute can be done by mail OR fax (717-259-6061 FAX). Queries can be sent by email.

Prices include shipping and handling within the US

Be sure to check out our other products at Soundpsych.com:

Product Qty Unit Price Ext Price
Subtotal:
Click here if you live in Sales Tax:
Grand Total:

Billing Info
Name:
Company:
Address1:
Address2:
City, State, Zip:
Phone:
Email address:

Ship To
Name:
Company:
Address1:
Address2:
City, State, Zip:
Phone:
Email address: