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Back2College Order Form

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scholarships2-7719525Print out this form and mail it to Back2College, 137 E Elliot #1553, Gilbert, AZ, 85299-1553. Thank you!

Name: _________________________________ Company/Institution: _____________________________ URL: ________________________________________ Street Address: _______________________________ City: ______________ State_____ Zip Code_______ Telephone: _____________ Fax: _________________ E-Mail (Required)__________________ Credit Card: Visa _____ MasterCard _____ American Express _____ Discover _____ Account number_____________________________ Exp. Date_______ Name as it appears on the card_________________________________ Signature _____________________________________ (Unsigned orders cannot be processed)

______ Payment by Check/Money Order (Payable to Back2College)

______ Please e-mail the eBook, Scholarships for Re-entry Students: Grants and Retraining Assistance for Adults Returning to College. Enclosed is $14.95. (Allow at least two to three weeks for payment processing.)

Go Back to School
Go Back to School