A Talk With Your Kids About Smoking   Video Upgrade Form

Please print out this form, or the form in Adobe Acrobat, and mail it with your check payable to Tobaccofree.org. Send to the address below. We use PayPal.com for credit card payments; see bottom of this form for instructions.

The cost is $75.00 to upgrade A Talk With Your Kids About Smoking to the version licensed for school use. You will be sent a separate video titled The Truth About Tobacco, which comes with a Teacher's Classroom Discussion Guide. On average, schools pay $60 to $145 for educational videos. For more about why the cost is so high, see Why is the price so high?
                           Upgrade   $75.00
Specify:  VHS    DVD                                                      Shipping     $5.00

In California, add 8.25% sales tax, or $6.19. CA sales tax: $________

Total enclosed  $______

Please make your check payable to Tobaccofree.org.

Print out this form, and mail with your check to:

PO Box 492028                              TEL(800) 541-7741
     Los Angeles CA 90049-8028                                                                          

Ship to:


School or Company____________________________________________________


City / State / Zip_____________________________________________________
Video and
receipt will be sent to the above address. Specify DVD or VHS.

Phone (Required)______________________________

Credit cards We only accept payment by credit card if you send it using Paypal.com. Click on Send Money, then Sign up if you are new (it’s free). email your payment to lupe (at) anti-smoking.org and also fax this form to (310)471-0335.

Return policy We accept returns for 30 days. Customer pays return shipping; please enclose receipt.