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How do I fill this out?

Filling out this form is straightforward. Start by providing your personal and shipping information. Remember, no PO boxes are accepted.

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How to fill out the Southern Farm Bureau Child-Saver Program Form?

  1. 1

    Provide your member name, county, member number, and state.

  2. 2

    Fill in your name, address, and phone number.

  3. 3

    Choose if UPS will deliver to a business or residence.

  4. 4

    Select the quantity and model of car seats you are ordering.

  5. 5

    Calculate the total and make payable to CHILD SOURCE.

Who needs the Southern Farm Bureau Child-Saver Program Form?

  1. 1

    Farm Bureau members who need affordable car seats for their children.

  2. 2

    Parents needing to replace or upgrade their child's car seat.

  3. 3

    Caregivers in rural areas seeking convenient car seat options.

  4. 4

    Families who prefer delivery directly to their home or business.

  5. 5

    Members wanting a straightforward ordering process for child safety seats.

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With PrintFriendly, you can easily edit your PDF form with our intuitive editor. Add or modify text fields without any hassle. Make your changes and download the correctly formatted PDF.

  1. 1

    Open the PDF form using PrintFriendly.

  2. 2

    Use the editing tools to enter your personal and shipping information.

  3. 3

    Select car seat models and quantities.

  4. 4

    Calculate the order total and fill in the required payment details.

  5. 5

    Save and download the edited PDF to submit.

What are the instructions for submitting this form?

To submit this form, mail it along with a check or money order to: CHILD SOURCE, 305 Lake Road, Medina, OH 44256. Ensure all lines are filled out and use black ink if handwriting. For questions, call Child Source Customer Service at 800-815-6330 ext 118. No fax, phone orders, or credit cards are accepted. Allow 2-3 weeks for delivery.

What are the important dates for this form in 2024 and 2025?

This form is updated periodically. Check the latest version each year before placing an order to ensure compliance with current terms and pricing.

importantDates

What is the purpose of this form?

The Southern Farm Bureau Child-Saver Program Order Form is designed to allow Farm Bureau members to order car seats at a reduced cost. The program aims to facilitate access to affordable child safety seats for members. By completing this form, members can specify their order details and ensure correct processing.

formPurpose

Tell me about this form and its components and fields line-by-line.

This form consists of fields requiring member, shipping, and order details needed to process the car seat order.
fields
  • 1. Member Name: The name of the Farm Bureau member placing the order.
  • 2. County: The county in which the member is located.
  • 3. Member No.: The membership number required for order processing.
  • 4. State: The state in which the member resides.
  • 5. Name: Full name of the person to whom the order will be shipped.
  • 6. Address: Physical address for delivery (no PO boxes).
  • 7. Daytime Phone #: Phone number in case of questions about the order.
  • 8. Email: Email address for order confirmation or inquiries.
  • 9. Model: Specific car seat model being ordered.
  • 10. Qty: Quantity of each car seat model ordered.
  • 11. Total: Calculated total cost of the order.

What happens if I fail to submit this form?

Failing to submit this form may result in delayed or unprocessed orders.

  • Missed Deadlines: Orders not placed on time may not be fulfilled.
  • Incomplete Information: Missing details can lead to processing delays.

How do I know when to use this form?

Use this form when you need to order affordable car seats through the Southern Farm Bureau Child-Saver Program.
fields
  • 1. New Orders: Submit a new order for car seats.
  • 2. Replacement Orders: Order replacements for existing car seats.
  • 3. Membership Verification: Confirm your membership status and eligibility.

Frequently Asked Question

How do I fill out the Child-Saver Program Order Form?

Use the provided space to enter your member and shipping details, select car seats, and total your order.

Can I use a PO box for delivery?

No, you must use a physical address for UPS delivery.

How many car seats can I order?

You can order a maximum of 3 seats.

Where do I send the completed form?

Mail the form with payment to CHILD SOURCE, 305 Lake Road, Medina, OH 44256.

How long does delivery take?

Please allow 2 to 3 weeks for delivery.

Can I pay with a credit card?

No, only checks or money orders are accepted.

What if I have questions about my order?

Call Child Source Customer Service at 800-815-6330 ext 118.

What information do I need when I call customer service?

Have your Farm Bureau member number ready.

Can I edit the form on PrintFriendly?

Yes, use PrintFriendly's PDF editor to fill out and edit the form.

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Yes, you can add your signature using PrintFriendly's signing feature.

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Southern Farm Bureau Child-Saver Program Form

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