N E X T G E N E R A T I O N K I O S K C U S T O M I Z A T I O N F O R M

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Use the following pages to select the items you are ordering, as well as how you wish them to be customized.

Please specify who is to receive the Quote for this order (select one):

o Customero Parish Consultant

Once you receive your Quote, please contact your Parish Consultant or our Customer Support team at (866) 767-3155 to pay for your order. You can make a credit card payment over the phone, or send a check for the total amount. Please make checks payable to:

Augustine Institute303 E State StreetSycamore, IL 60178

Fill out your contact info below. Your Parish Consultant will send you a Quote with the total for the order, complete with shipping and handling fees and sales tax (if applicable). Augustine Institute ships UPS using competitive rates based upon the weight of the order and location of the shipping address.

Name Date

Phone ( ) Email

Parish name Parish Zip / Postal Code

Shipping address (no P.O. boxes accepted)

City State Zip

Kiosk ministry coordinator Parish Consultant

KIOSK REORDER PRICING CHARTBooks (1 title)

1–4 $5.00 each5–9 $4.00 each

10–24 $3.75 each25–99 $3.45 each

100–249 $3.20 each250–499 $2.90 each

500+ $2.30 eachBooks outside the U.S. & Canada:

1–499 $5.45 each500+ $3.65 each

DVDs $4.25 each

Multi-CD sets $8.25 each

Pamphlets $13.50 per 50-pack

Knights of Columbus bookletsAll quantities $1.00 each

FOR TAX EXEMPT CUSTOMERS ONLY: If we do not have your exemption certificate in our files, please fax a copy to (815) 895-0333, or email it to customer.service@lighthousecatholicmedia.org

CDs (1 title)1–4 $3.20 each5–9 $2.85 each

10–249 $2.75 each250–499 $2.65 each500–999 $2.45 each

1000+ $2.25 each

Booklets (1 title)1–4 $2.00 each5–9 $1.95 each

10–24 $1.85 each25–99 $1.75 each

100–249 $1.50 each250–499 $1.50 each

500+ $1.50 each

SELECT ADDITIONAL MODULES

BOOK MODULEHolds 24 books (4 titles)$20.90

BOOKLET MODULEHolds 150 booklets (5 titles)$18.59

MAGNETIC BULLETIN MODULEHolds 150 bulletins (3 issues)$75

CD MODULEHolds 80 CDs (8 titles)$39.05

DVD/MULTI-CD MODULEHolds 12 DVDs (4 titles) or 4 multi-CD sets (4 titles)$23.10

DELUXE PAMPHLET MODULEHolds 40 deluxe pamphlets (4 titles)$46

PAMPHLET MODULEHolds 250 bulletins (5 titles)$36

DIVINE MERCY KITIncludes 6 books, 4 booklets, 20 CDs, 100 pamphlets, and 100 prayer cards$197

3UNITS OFHEIGHT

2UNITS OFHEIGHT

use only on lower mounted uprights

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UNITS OF HEIGHTUse this guide to determine how many

modules your kiosk can hold on one side.

Tall standing: 13Tabletop: 10

NOTE: In starter kits, module selection CANNOT be customized. This form may be used to order additional modules to fit your kiosk(s).

FULL-SIZE STANDING KIOSKC U S T O M I Z E Y O U R S TA RT E R K I T

Deselect any titles that you DO NOT want

CDs (10 of each title)o Angels Explained | Dr. Mark Miravalleo Confession | Fr. Larry Richardso Down to Earth | Mark Harto The Fourth Cup | Dr. Scott Hahno From Love, By Love, For Love | Fr. Michael Schmitzo Prove it God! ...and He Did | Patty Schneiero Relativism | Chris Stefanicko What’s So Great About Being Catholic | Jason Evert

DIVINE MERCY MODULE (not customizable)33 Days to Morning Glory | Fr. Michael Gaitley (4)Consoling the Heart of Jesus Prayer Companion | Fr. Michael Gaitley (4)The Diary of St. Faustina (2)Divine Mercy 5 x 7 images (50)Divine Mercy Novena and Chaplet pamphlet (50)HAPP brochure (50)Immaculata 5 x 7 images (50)No Turning Back | Fr. Donald Calloway (10)The Second Greatest Story Ever Told | Fr. Michael Gaitley (10)

BOOKS (6 of each title)o Crossing the Tiber | Stephen Rayo Joan of Arc | Mark Twaino My Sisters the | Colleen Carroll Campbell o New Testament (RSV-2CE)o Jesus and the Jewish Roots of the Eucharist | Dr. Brant Pitreo Everything You Ever Wanted to Know About Heaven | Dr. Peter Kreefto The World’s First Love | Venerable Fulton J. Sheeno Render unto Caesar | Archbishop Charles Chaput

BOOKLETS (5 of each title)o Augustine of Hippo o Catholicism and Other Religions o Message of Guadalupeo Pope Franciso What Catholics Believe

Deselect any titles that you DO NOT want

CDs (10 of each title)o Anger and Forgiveness | Deacon Dr. Bob McDonaldo Answering Atheism | Ken Hensleyo Finding the Fullness of Faith | Stephen Rayo For Love and Marriage | Johnnette Benkovico The Healing Power of Confession | Dr. Scott Hahno I’m Not Being Fed | Jeff Cavinso Jesus Is... | Fr. Michael Schmitzo Life is Worth Living | Venerable Fulton J. Sheeno The Mass Comes Alive (episode 1) | Cat.Chato The Mass Explained | Fr. Larry Richardso The Second Greatest Story Ever Told | Fr. Michael Gaitleyo Lectio Divina | Dr. Tim Grayo Trust in the Lord | Msgr. Thomas Richtero Who Do You Say That I Am? | Fr. Robert Barrono Why a Protestant Pastor Became Catholic | Dr. Scott Hahno Why Be Catholic? | Patrick Madrid

BOOKS (6 of each title)o 33 Days to Morning Glory | Fr. Michael Gaitleyo Catholicism | Fr. Robert Barrono Meet Your Mother | Dr. Mark Miravalleo Rome Sweet Home | Scott & Kimberly Hahn o The Hidden Power of Kindness | Fr. Lawrence Lovasiko 7 Secrets of Confession | Vinny Flynno Bible Basics | Dr. John Bergmsao By What Authority? | Mark Shea

BOOKLETS (5 of each title)o Is Jesus Really Present in the Eucharist?o Pier Giorgio Frassatio Prayer Book for Spouseso Sexuality and Loveo What Happened at Fatima

Enter any titles you wish to include that are not part of the standard starter kit

F R O N T S I D E

A D D I T I O N A L T I T L E S

B A C K S I D E

T I T L E T I T L EQ T Y Q T Y

Deselect any titles that you DO NOT want

CDs (10 of each title)o For Love and Marriage | Johnnette Benkovico The Healing Power of Confession | Dr. Scott Hahno I’m Not Being Fed | Jeff Cavinso Jesus Is... | Fr. Michael Schmitzo The Mass Explained | Fr. Larry Richardso Lectio Divina | Dr. Tim Grayo Why a Protestant Pastor Became Catholic | Dr. Scott Hahno Why Be Catholic? | Patrick Madrid

BOOKS (6 of each title)o 33 Days to Morning Glory | Fr. Michael Gaitleyo Catholicism | Fr. Robert Barrono Meet Your Mother | Dr. Mark Miravalleo Rome Sweet Home | Scott & Kimberly Hahn

BOOKLETS (5 of each title)o Is Jesus Really Present in the Eucharist?o Pier Giorgio Frassatio Prayer Book for Spouseso Sexuality and Loveo What Happened at Fatima

F R O N T S I D E

A D D I T I O N A L T I T L E S

T I T L E T I T L EQ T Y Q T Y

MID-SIZE NEXT GENERATION KIOSK WOODEN

Deselect any titles that you DO NOT want

CDs (10 of each title)o The Healing Power of Confession | Dr. Scott Hahno Jesus Is... | Fr. Michael Schmitzo Real Womanhood | Lisa Cottero Relativism | Chris Stefanicko The Second Greatest Story Ever Told | Fr. Michael Gaitleyo Lectio Divina | Dr. Tim Grayo Who Do You Say That I Am? | Fr. Robert Barrono Why Be Catholic? | Patrick Madrid

BOOKS (5 of each title)o 33 Days to Morning Glory | Fr. Michael Gaitleyo The Lamb’s Supper | Dr. Scott Hahn

BOOKLETS (5 of each title)o Is Jesus Really Present in the Eucharist?o Pope Franciso Prayer Book for Spouseso Sexuality and Love

F R O N T S I D E

Enter any titles you wish to include that are not part of the standard starter kit

A D D I T I O N A L T I T L E S

Enter any titles you wish to include that are not part of the standard starter kit

TABLETOP DISPLAYSC U S T O M I Z E Y O U R S TA RT E R K I T