Dancing Thru Pregnancy: Order Form

On-line Order Form

NOTE: This form required a forms-capable Web browser. If you do not see text areas below or cannot use forms, please use our print and fax order form, or call 1-800-442-9034. Additional information is also available through our comment form. Thank you.

Your Full Name:

Your Mailing Address:

City: State: Zip or Postal Code Country

Phone number for Contact:

It is very important that you enter a phone number where we can reach you at. All orders through the internet must be voice verified for your protection and ours. Please enter a time that is convenient for us to contact you.

You should receive verification of this order within 24 hours. Again, orders can only be filled after voice verification. Thank you.

Fax Number:

Email Address:

World Wide Web Page:

Purchase

Pre/Postnatal Products:

I would like to order the following items:

QTY. $50 Pre/Postnatal Health and Fitness Instructor's Manual and workbook.
QTY. $20 Dancing Thru Pregnancy/AfterDance T-shirt.

CT residents add 6% sales tax

NY residents add local rate

TOTAL:

Today's date:

Request for Information

I would like to receive more information about the following:

Consumer Consultation Service

Qualified Health & Fitness Educators in my area

Continuing Education

Instructor Training

Licensing and Program Development

Aditional Comments, Questions, Suggestions:

Before submitting this form, please re-check the information you have entered to make sure it is correct. Also make sure the phone number and time for contact you have entered are correct as no orders can be filled without voice verification.

Thank you for your order

For more information, send e-mail to:
Ann Cowlin / ann.cowlin@yale.edu

Fill out our comment form:

Or send mail to:
Dancing Thru Pregnancy, Inc. / Box 3083 Stony Creek, CT 06405 / 1-800-442-9034