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APPROVED WORKMAN ORDER FORM                  

Please print this page, fill in the information, then mail it along with your check to the address shown below.

 

- Please Print -

  
Church Name:    
Church Street Address:    
Church City, State, Zip:    

Church Website:

    
Club Name:
   (e.g. FBC Awana Club)		    

Contact Person:
   (Person to receive updates)

    
Contact Phone:    
Contact Email:    
Club Size
   (approx # clubbers)		    
Comments:    
#Users Price  
 [_] 1        
 [_] 2        
 [_] 3        
 [_] 4        
 [_] 5         
 [_] ___ *  		$149
$199
$249
$299
$349 
$_____ *

The initial purchase price includes the annual support plan
through July 1.

* Pricing structure:  $149 for the first license, plus $50 for each additional license.

  Wisconsin churches only, please include your tax exempt # : ______________

Make check payable and mail to:    

            Thank You!		 Leffler Systems       
877 Duncannon Way
Sun Prairie, WI 53590