Gateway Student Mail Order Form

Gateway Student

Order Form to be mailed with payment to:
Gateway Student
PO Box 20047, Rochester, NY 14602

(note: money order and bank check purchases shipped immediately upon receipt of payment, personel checks must clear before shipping)

Program(s):
The New SAT Advantage ($199.00) - Quantity
New Learning Edge DVD's ($795.00) - Quantity

Total included:
Payment Type:

Date (dd/mm/yy):
Your Name:
E-mail Address:
Phone:
Street Address:
City:
State:		Zip:
Fill out the questions below to credit your mentor (if you have one):
Mentor ID :
Mentor Name:

Special instructions or comments (optional):
Print a copy of your order to include with your mailed payment
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