Ordered by: Name ___________________________________ Address _________________________________ City / State / Zip __________________________ Phone __________________________ |
Ship to: Name ___________________________________ Address _________________________________ City / State / Zip __________________________ Phone __________________________ |
Title __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Handling ($3.50 for books, $1.50 for 1st magazine $.50 for each additional magazine) |
Quantity _____ _____ _____ _____ _____ |
Price Each __________ __________ __________ __________ __________ 7% tax |
Subtotals __________ __________ __________ __________ __________
__________ |
_____ Payment enclosed for $ _________________________ _____ Charge to _____ Visa _____ Mastercard Card Number ____________________________ Expiration Date ________________ Signature ________________________________ |