North Pole Postman—Printable Order Form This is the form where parents can write to Santa and let him know what their child has “really” been up to this year! Print one copy for each child receiving a letter from Santa. You can send it back to us by using any of the three options below: email: orders@northpolepostman.com FAX: (877) 342 1784 Snail Mail: North Pole Postman 11 Toner Boulevard, Suite 5-361 North Attleboro, MA 02760 USA Please note: Our deadline for orders to the U.S./Canada is December 20*, and for all other countries our deadline is December 15*. *we cannot guarantee a North Pole Stamp Cancellation after Dec. 15 for U.S./Canada orders or after Dec. 10 for all other countries. Your Name: Your Address: Your City: State/Province: Zip/Postal code: Your Country: Your Phone Number: Your Email: Your relationship to the child receiving this letter (parent, grandparent, legal guardian, other—please explain): Child‟s Name: Child‟s Address: Child‟s City: State/Province: Zip/Postal code: Child‟s Country: Is this child a „boy,‟ or „girl‟? Boy Girl Child‟s age after December 1, 2011: Child‟s Grade in School (if applicable): Is this child an „only child?‟ Yes or No Will you be ordering additional letters for siblings, or other children in the same household? Yes or No Does this child have a chimney on their home? Yes or No or Not Sure Optional Information: While we respect your privacy (and your child‟s privacy), answer only the questions which you are comfortable. However, please keep in mind, the more information we have about your child, the more personal, and authentic we can make his/her letter. All of the questions below are optional. Toy(s) on your child‟s “wish list”: Name of Child‟s teacher (if applicable): Name of Child‟s Pet(s) (if applicable): Type of pet (dog, cat, hamster, etc.): Please mention one or two things this child has excelled in during the past year (learning how to walk, ride a bicycle, tie his/her shoe, winning a trophy, etc.): Please mention one thing the child needs to work on (doing their homework, cleaning their room, eating their vegetables, etc.): Optional: Are there any unique or unusual circumstances that you would like us to be aware of (child is handicapped, disabled, autism, nontraditional family environment, financial hardships, etc.)? Please enter payment information on the next page. If you are submitting multiple order forms together (ordering for more than one child), you only need to print one copy of the next page. All prices are in U.S. Dollars, and include sales tax and shipping. Please write the correct quantity next to the product purchase options below: _______Yes! I would like to preorder an autographed copy of „Post‟ Mark—Santa‟s Misfit Postman for $15.95, and receive a free letter from Santa, a $9.95 value. I understand by choosing this option that my free letter from Santa will arrive before Christmas of 2011, but the book will not be shipped until November 2012. If you would like a personal inscription on your autograph, please indicate your message here (examples: “Merry Christmas Austin,” or “Santa loves you, Julie”): _______No Thank you. I would like to just purchase the letter for $9.95. For each item you purchase the North Pole Postman will donate $1 to the Vanessa Behan Crisis Nursery (Spokane, WA), or the Liam B.W. Davis Special Needs Trust (Quincy, MA). Please circle your preference. If you would like to donate an additional amount above the $1 donation, please indicate the amount here (or enter N/A/): $________________ ___________ Please enter your total here. All prices above include tax and shipping. Authorization to Apply Charge to Credit or Debit Card Card Type (circle one): Visa Master Card American Express Discover Card Number:________________________ Expiration Date:____________ Verification Code (on back of card):_______ Name exactly as it appears on card:________________________________ Credit Card Billing Address:_______________________________________ _____________________________________________________________ Printed Name:_______________________________ Date:_____________ Authorized Signature:_________________________ Date:_____________ Please Note: If you are ordering more than one letter, and submitting multiple order forms together, you only need to fill out your credit card information on one form. You may also enclose a check for the correct total, if you prefer.