School Mediation Associates Order Form

This form is not for ordering on line. Print the form out, fill it in, and post it back to us. Or you can order books by phone by calling us toll free at 800-833-3318.

Please Send:

___ copies of The School Mediator's Field Guide at $29.95 per copy ______
___ copies of Students Resolving Conflict at $29.95 per copy ______
___ copies of Mediation: An Alternative That Works Video at $29.95
Please circle your preferred video format, DVD or VHS tape
___ Information about School Mediation Associates _Free_
Subtotal: ______
Sales Tax:
Please add 5% for books shipped to Massachusetts addresses

Within the United States:
$4.50 for first book/video; $2.50 for each additional book/video
Outside the United States: Postage costs and currency exchange fees vary widely
(and are often quite expensive).
Contact us at for more information.

Total: ______
(All orders should be paid in US dollars.)
Payment (check one):
___ Check enclosed (Made out to "School Mediation Associates")
___ Bill my school (must include PO #) PO #: ______________
___ MasterCard
___ Visa
Credit Card #: _________________________
Expiration Date: __________
Cardholder's Signature: ____________________________
Name: __________________________________________________________
School Name: ____________________________________________________
Address (home or school): _________________________________________
City: ________________________________   State: _____   Zip: _________
Telephone: ________________________
Email: __________________________________________________________
I would like to receive The School Mediator, a free monthly EMAIL newsletter ______
(We need your EMAIL address in order to send the newsletter to you!)
How did you first learn about our materials: _____________________________________