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Information Request

Please note: Although it is likely that you will not experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: customerservice@verbathon.com.

How to Order?

You may request for further information on the Verbathon Language Method for free by filling out this form. After completing the form and submitting your request, you will receive an email confirmation within 24 hours.

Name
School/Organization
Address1
Address2
City
Province/State
Zip/Postal Code
Country
Telephone (area code first)
Fax No (area code first)
E-mail

How did you hear about us? (choose one)
Internet Search
Referred by colleague/friend
Heard from a Conference
Publication such as a magazine advertisement, article, etc.

What area of teaching are you in? (choose one)
Teacher
Teaching Assistant
Teacher/Principal
Principal
Consultant
Other (specify in the "Referred by/Comments" section)

How do you connect to the Internet? (choose one)
ADSL High Speed
Cable High Speed
T1/T3 or faster connection
Dial Up 56K Connection
Dial Up 36K Connection
Dial Up 28.8K or slower

What Languages do you or your organization teach? (may choose more than one)

  1. Spanish
  2. French
  3. German
  4. Other (specify in the "Referred by/Comments" section)

Referred by/Comments:

Please contact us if you have any further questions!

 

 

 

 


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