| Member ____ |
Non-member ____ |
|
|
|
Number of books |
_______ |
|
|
Total amount enclosed |
_________________ |
|
$23 per book including shipping for members
$25 per book including shipping for non-members |
|
Date |
_________________ |
|
|
|
Name* |
____________________________________________ |
|
Mailing Address |
____________________________________________ |
|
City/State/Zip |
____________________________________________ |
|
Company |
____________________________________________ |
|
Phone |
____________________________________________ |
|
E-mail |
____________________________________________ |
Signature |
____________________________________________ |
*If membership is under a different name, indicate membership name here: |
____________________________________________ |