BMI Home School Program

Email Order Form	If you need to order more than five items then please submit this form as many times as you need to fill your order. If you are paying using PayPal our account is baileymilitary@att.net. If you are paying using cash, check, or money order our address is: Bailey Military Institute; 2626 S. Loop Suite 650-M; Houston, TX 77054. Please make all checks out to Bailey Military Institute. Items will not be shipped until payment is received.
First Name: Last Name: Phone Number: Address Line 1: Address Line 2: City: State/Province: Country: Zip/Postal Code: Payment OptionCashCheckMoney OrderPayPal Payment Information (Check Number, PayPal Account) 1a. Item Name: 1b. Quantity: 1c. Notes 2a. Item Name: 2b. Quantity: 2c. Notes 3a. Item Name 3c. Quantity 3c. Notes 4a. Item Name 4b. Quantity 4c. Notes 5a. Item Name 5b. Quantity 5c. Notes Delivery Instructions: Other Comments: