Order Form

SchoolPlace 2.0 (long form) Project Setup Form

By filling in this form and clicking on the "Submit" button, you will send an order via E-mail to the CentACS headquarters in Charlotte, NC, USA. You must be registered with CentACS as a qualified or certified Big Five consultant for us to complete the order. If you prefer, you may print the form and fax it, completed, to us at 704-331-9408.

If you are outside the United States, we may refer your order to one of our global affiliates nearer to you.
If you have made prior billing arrangements with us, then we will process your order immediately.
If you have not made prior billing arrangements with us, then we will need to contact you by E-mail or telephone.
When you have a critical deadline for receiving your order, we suggest that you telephone your order to CentACS at 1-800-244-5555 or +1-704-331-0926.

Please provide the following contact and project information:

Consultant Name

Project Title

Ship to Arrive Date

(or Pick-Up Date)

Choose one of the following options for type of project:

By what method would you like the questionnaires delivered?

How would you like the reports to be delivered?

(Note: The CentACS policy is that reports are sent to the qualified or certified consultant and not sent directly from CentACS to the end user.)

What report(s) do you need?

Supertraits & Subtraits
Leader

Career Guider

Learner

Here please enter the name and e-Mail (if appropriate) of each person who will be taking the questionnaire(s), as you would like the names to appear on the reports.

If you want questionnaires emailed directly to the participants and checked that box earlier, then include name and e-Mail address; otherwise just list the names.

Input the "Subject" information for the E-mail that will be sent to the individual who will be receiving the questionnaire:

If you would like to specify the E-mail message sent with the questionnaire (instead of the standard CentACS E-mail), please input it here:

Use the shipping address that CentACS already has on file?

Use the billing information that CentACS already has on file?

If you answered "Yes" to both of the two preceding questions, then you may skip to the end and "Submit" your order. Thanks!

If you need to specify a shipping address that is different from the one that CentACS has on file, please do that here:

Ship to Address

(if applicable)

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

FAX

E-mail

If your "bill to" address is different from the "ship to" address, and we do not have it on file for you, please enter here:

Name

Bill to Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Finally, please enter in the following space any other products you need, along with quantity and any other pertinent information.

Specify any other comments:

Ship to Address (if applicable)
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

Name
Bill to Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Copyright © 2007 CentACS--Center for Applied Cognitive Studies. All rights reserved.