Customer Order Form

Contact Name

Business Entity Name

Mailing Address

City, State Zip 00000-0000

Area Code + Telephone 000-000-0000

Area Code + Facsimile 000-000-0000

E-Mail Address

Web Site Address http://www.

Briefly Describe Desired Service

STATE & APPROXIMATE NUMBER OF PRIVATE SCHOOLS IN NPSAA DATABASE (50,094 K-12 + 80,549 PK = 130,643 TOTAL IN DATABASE)

1. ALASKA 269 K-12 + 316 PK = 585

2. ALABAMA 759 K-12 + 1375 PK = 2134

3. ARKANSAS 387 K-12 + 911 PK = 1298

4. ARIZONA 886 K-12 + 987 PK = 1873

5. CALIFORNIA 6429 K-12 + 8498 PK = 14927

6. COLORADO 647 K-12 + 1147 PK = 1794

7. CONNECTICUT 882 K-12 + 1190 PK = 2072

8. DIST OF COLUMBIA 157 K-12 + 236 PK = 393

9. DELAWARE 151 K-12 + 276 PK = 427

10. FLORIDA 2289 K-12 + 4735 PK = 7024

11. GEORGIA 976 K-12 + 2349 PK = 3325

12. HAWAII 263 K-12 + 293 PK = 556

13. IOWA 495 K-12 + 901 PK = 1396

14. IDAHO 169 K-12 + 401 PK = 570

15. ILLINOIS 2260 K-12 + 2508 PK = 4768

16. INDIANA 988 K-12 + 1415 PK = 2403

17. KANSAS 493 K-12 + 956 PK = 1449

18. KENTUCKY 541 K-12 + 1165 PK = 1706

19. LOUISIANA 1000 K-12 + 1490 PK = 2490

20. MASSACHUSETTS 1771 K-12 + 1933 PK = 3704

21. MARYLAND 905 K-12 + 1680 PK = 2585

22. MAINE 403 K-12 + 461 PK = 864

23. MICHIGAN 1931 K-12 + 2828 PK = 4759

24. MINNESOTA 898 K-12 + 1372 PK = 2270

25. MISSOURI 1098 K-12 + 2262 PK = 3360

26. MISSISSIPPI 499 K-12 + 1259 PK = 1758

27. MONTANA 219 K-12 + 402 PK = 621

28. NORTH CAROLINA 1011 K-12 + 3561 PK = 4572

29. NORTH DAKOTA 118 K-12 + 241 PK = 359

30. NEBRASKA 372 K-12 + 775 PK = 1147

31. NEW HAMPSHIRE 271 K-12 + 689 PK = 960

32. NEW JERSEY 1857 K-12 + 3305 PK = 5162

33. NEW MEXICO 282 K-12 + 441 PK = 723

34. NEVADA 157 K-12 + 301 PK = 458

35. NEW YORK 3545 K-12 + 3371 PK = 6916

36. OHIO 2060 K-12 + 2666 PK = 4726

37. OKLAHOMA 485 K-12 + 1388 PK = 1873

38. OREGON 570 K-12 + 1077 PK = 1647

39. PENNSYLVANIA 3236 K-12 + 3148 PK = 6384

40. RHODE ISLAND 180 K-12 + 265 PK = 445

41. SOUTH CAROLINA 590 K-12 + 1413 PK = 2003

42. SOUTH DAKOTA 181 K-12 + 213 PK = 394

43. TENNESSEE 745 K-12 + 1700 PK = 2445

44. TEXAS 2642 K=12 + 5887 PK = 8529

45. UTAH 211 K-12 + 399 PK = 610

46. VIRGINIA 865 K-12 + 1769 PK = 2634

47. VERMONT 223 K-12 + 234 PK = 457

48. WASHINGTON 887 K-12 + 2011 PK = 2898

49. WISCONSIN 1464 K-12 + 1813 PK = 3277

50. WEST VIRGINIA 203 K-12 + 349 PK = 552

51. WYOMING 174 K-12 + 187 PK = 361

(Select here to return to the scroll option)

TOTAL APPROXIMATE NUMBER OF PRIVATE SCHOOLS K-12 50,094 + 80,649 PK = 130,643

YOU MAY NOT OPEN THE NPSAA DATA BASE ANYWHERE WITHIN THIS WEB SITE

Item # 1: NPSAA DATABASE OF PRIVATE SCHOOLS @ 15 cents each listing on CD.
$750 Minimum order. (Min 5,000/Max 130,643) Private Schools @ 15 Cents Each School Listing.
Order Unit requires Min 1 State, then (State by State) State data is Bulk. You Query & Sort per your use.

Name the State(s) & Private School Count

Total Private School Count

Enter Total Count X 15 Cents = $ 0.00

Item #2: MAILING LABELS - 25 cents each label. (pin feed or sheet feed).
$1,250 Minimum Order (Min 5000/Max 130,643) Private Schools @ 25 cents each school label.
Order Unit requires Min 1 State, then (State by State)_ State data is Bulk. We Query & Sort per your use.

Name the State(s) & Label Count

Total Label Count

Enter Total Label Count X 25 Cents = $ 0.00

Item #3: NPSAA ENDORSEMENT (non-exclusive) Use of NPSAA Name & Logo. Plus Courtesies.
$500 Min 1 State @ $500 Each State (State by State) Min order $500

Name the State(s) for Endorsement

Total No. State(s) Selected for Endorsement

Enter Total Count X $500 = $ 0.00

Item #4: NPSAA EXCLUSIVE ENDORSEMENT. (Protected Territory)
$750 Min 1 State @ $750 Each State (State by State) Min order $750

Name the State(s) for Exclusive Endorsement

Total No. State(s) for Exclusive Endorsement

Enter Total Count X $750 = $ 0.00

Item #5: DISTRIBUTION of your DIRECT RESPONSE MARKETING PIECE into the NPSAA Newsletter. Requires Min 1 State Endorsement @ $500 or $750 Exclusive Endorsement. Then you supply your printed 8 1/2 X 11 Tri-fold @ 15 cents each piece to be inserted in the NPSAA Newsletter. Note: Size & Weight restrictions apply. Order Unit requires Min 1 State, in bulk. Then (State by State) NPSAA sort.
(Insertions apply to next scheduled NPSAA Newsletter & are Pre-Paid).

Name the State(s) & School Count for Dist.

Total No. of Schools for Distribution

Enter Total Count X 15 Cents = $ 0.00

Item #6: NPSAA WEB SITE RESOURCE ADVERTISING
Viewed by Private School Administrators, Teachers & Staff, Parents & Students

A. Each Business CATEGORY Listing: $50/Month = $600/Year pre-paid
Includes Company Name, Contact, Address, Phone, Fax, E-Mail, Web Address & 25 Word Description.
Note: Active Links to LOGO, WEB ADDRESS & E-MAIL require additional fee.

B. Add each E-MAIL LINK: $25/Month = $300/Year pre-paid.

C. Add each WEB SITE LINK: $25/Month = $300/Year pre-paid.

D. Add each LOGO LINK: $25/Month = $300 Year pre-paid.

A. List Resource Category @ $ 600

B. List E-Mail Address Link @ $ 300

C. List Web Site Link @ $ 300

D. List LOGO Link @ $300

Total A + B + C + D = $ 0.00

I desire Express Service. Enter $ 25

Enter Total of all items ordered = $ 0.00

Items ordered, are pre-paid & processed within 10 business days unless expedited with express service and paid with certified funds. Make Check Payable to "National Private Schools" Your request will be acknowledged but not be processed without the proper remittence. Mail: 8815 Conroy-Windermere Road, Suite 413, Orlando, Florida 32835. Contact Dr. David L. Johns, President Voice: 407-522-0124

Enter Final Comments.