Order P.H.A.T

 

 

 

 

 

 

 

 

 

To order your copy, print this form out (or download PDF ORDER FORM) and send with a check or money order for $100 ($55 for organizations that work directly with low-income ethnic youth), plus 8.75% sales tax for orders from California, made payable to:
CANFit/Tides Center
2140 Shattuck Ave., Ste. 610
Berkeley, CA 94704

Or call 510-644-1533 with credit card information.

CONTACT NAME: ______________________________________________________________

PROGRAM AFFILIATION: ________________________________________________________

MAILING ADDRESS: ____________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

PHONE: _______________________FAX:__________________________

EMAIL: ________________________

Type of Program

Classroom After-School Community Health

Government Individual


Other____________________________

For more information visit: www.canfit.org or call 510-644-1533.