Learning Materials Requisition Fo

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Gifts from the Universe (GFTU), Train the Trainer Program
Learning Materials Requisition Form
Certified Trainer: _______________________________________ Email:___________________________________________ Phone number: __________________________
Shipping Address (street, city, state, country): ____________________________________________________________________________________________________________
All certified trainers are entitled to buy the following products at the deeply discounted prices specified. Free or subsidized orders are
available to certified trainers to the extent cash reserves are sufficient AND all of the following criteria are met (please initial each condition
met):
A. If applicable, please initial each condition that applies for subsidized or free material requests only:
____________The requested materials are solely for trainees who cannot otherwise afford them (the underprivileged, unemployed, etc.), AND,
____________The items will be immediately used in a confirmed and verifiable program (complete Part C, below), AND,
____________Trainees will be the end users of the materials and they will not later make the materials available to any commercial markets for
sale or trade, AND,
____________The trainees are not required to pay anything for either the materials or the training.
B. Please enter desired quantities:
Materials
Free Books Requested
Books to be Paid For
Cost per Item
Extended Cost
Infinite Possibilities, Paperback
$6.00
Infinite Possibilities, Workbook
$2.00
The Secret DVD – NTSC format
n/a *
* Trainers must either qualify for free copies of The Secret (using this form) or purchase them directly from
We are not authorized to stock copies of The Secret to sell.
C. Please give a detailed description of where the program will be delivered and who will be receiving these materials:
Location (Organization and Address): _______________________________________________________________________________________ Start date:_________________
Contact Person: __________________________________________ Phone number: _______________________________ Email address: _______________________________
# Students____________ Student Type (teens, homeless, recovering addicts, disadvantaged, etc.)______________________________________________________
D. I must have these materials in my hands by the following date (If you need these faster than normal surface delivery, plus 2 biz days
handling, you may have to pay for expedited delivery. Please try to order well in advance of your anticipated start date).
Date required: ___________________________
E. Optional Payment: If you would like to pay all or some of the costs for the above, including shipping, to help preserve GFTU funds, please
provide credit #, exp. date, security code, and bill to address:
_________________________________________________________________________________________________________________________________________________________________
For FREE or subsidized order requests only: I confirm that the above information is true and that I’m planning to deliver the "Infinite
Possibilities" Training Program in a non-profit nature as an unpaid, volunteer trainer and that the items I receive will be delivered directly to
the participants of this program at no cost, unless otherwise noted above. These participants will be the end users of the items, and they will
not later sell or trade them.
Signature: ________________________________________
Date: ________________________
Thank you! You will be contacted promptly regarding this requisition and informed of the % GFTU may subsidize.
Email applications to or fax to 407‐488‐1981
Revised as of 15-Aug-12

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