Page 1 of 5
Invoice Request
- Walking Wise Learning Center
Purchaser Information
Referral from The Innocent
Full Name of Purchaser
*
Title of Purchaser
*
Phone Number of Purchaser
*
Email of Purchaser:
*
Organization's Name
*
Organization's URL
*
Street Address
*
City
*
State / Province
*
Zip / Postal Code
*
Country
*
Full Name of Program Manager
*
Emal of Program Manager
*
A/P Contact Name:
*
A/P Contact's Email:
*
Enter PO#, if required:
Is your organization Tax Exempt?
*
A
YES
B
NO
If yes, provide Tax Exemption ID# AND send document to:
support@WalkingWise.com
Payment Method
Tax Exempt Account
: Required Payment Method is U.S. Bank Account
Taxable Account
: Required Payment Method is Credit Card
Message:
Next
