SMARTS Elementary Presale Order Form Name* First Last Email* Enter Email Confirm Email School Email (if different)Phone*School/Organization*City*State*Zip code*Professional TitlePlease select one. Special Education Teacher General Education Teacher School Level Administrator (e.g., Principal) District Level Administrator (e.g., Assistant Superintendent) Higher Education (e.g., professor) Therapist (e.g., SLP, OT, Educational Therapist) Psychologist/Psychiatrist School Counselor Independent Educational Professional (e.g., coach, tutor) Parent Other (Please define) Professional Role*Special Education TeacherGeneral Education TeacherSchool Level Administrator (e.g., Principal)District level Administrator (e.g., Assistant Superintendent)Higher Education Professional (e.g., Professor)Therapist (e.g., SLP, OT, Educational Therapist)Psychologist/PsychiatristSchool CounselorIndependent Educational Professional (e.g., coach, tutor)ParentNumber of licenses you'd like to purchasePlease enter a number greater than or equal to 1.Special pricing is available through June 30th. To receive this discounted pricing, this form must be received by June 30th at midnight.1-4 licenses: $495 per license (reg. $595); 5+ licenses: $425 I understand Please enter the name, title, and email of the educator(s) who will receive the license (if different than the person filling out this form)Please select your preferred method of payment. If you select 'Pay by Credit Card' a PayPal invoice will be sent to the email you provided. If you select 'Pay with Purchase Order' we with instructions on how to submit your PO. Select One*Pay by Credit CardPay with Purchase Order* Indicates a required field.