Great Brook Order Form
Thanks for your interest in our products.
Currently offerings on this order form include our Customer Surveying book on how to create a survey,
and a report on how to add design for supportability into your product design processes.
Our our Survey Mentor product suite provides survey consulting services.

Finally, our Survey Workshops will help you write better survey questions.
For Survey Workshops please use our workshop registration form.
Product & Shipment Information
+ All prices are in US dollars. +
+ Sales tax of 6.25% will be added for Massachusetts residents. +
+ If you are ordering many items, please go to and Contact Us +
*Product Order & Quantity:  
2nd Product Order:  
++ We use US Postal Service (USPS) as our shipper. ++
~ Shipping rates shown are per item ordered. Shipping cost for additional items are half off. We will calculate total. ~
~ Items ship from Massachusetts in USA. For shipments to Mass., we will add sales tax. ~
~ First 3 shipping options are for US only. ~
~ International shipping via USPS Priority Mail may not be available. We will contact you in that case. ~
International customers, please read shipping details.
*Shipping Method  
Billing Information
*First (Given) Name:   Same name as on your card
Middle Initial:   if paying by credit card
*Last (Family) Name:  
Job Title:  
*Address Line 1:   Where your statement is mailed
Address Line 2:   Apt. or Suite No.
State or Province:   Use your country`s abbr.
*Postal (Zip) Code:   Zip Code in US
Phone:   Used if problems w/order info
Shipping Information
Same As Billing Info   If same, please check box
First (Given) Name:   and leave these fields blank
Middle Initial:  
Last (Family) Name:  
Address Line 1:  
Address Line 2:  
State or Province:  
Postal Code:  
Payment Information
* If paying by check, please mail a copy of this form with your check to:
Great Brook, 421 Main St., Bolton, MA 01740 USA
* All checks must be in US funds drawn on a US bank.
*Payment Method
We prefer MC & Visa
Referral & Book Signing Information
Would you like the book signed by the author?
As a small business, we greatly appreciate information about how you found us.
How did you hear about us?
Colleague Referral
We prefer MC & Visa
Tell us more if you wish...  
If you used a search engine, what type of listing led you to our web site?
Was it a....
Block ad on the right side of the search results page?
"Organic" listing on left side of the search results?
What search keyword phrase did you use?   This is very helpful!
Thanks for your Order!
Click on Submit Order to send your information.

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