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O R D E R F O R M
Name:
Address: Apt#:
City:
State/Province: Zip:
Country:
Phone: Fax:
Email: URL/Web
Address:
Date:
Please Send Me:
Copies of
Used Book Name:
Price Per Book:
Add $5.00
For Shipping and Handling:
NY State Residents -
Include Sales Tax:
My Check, Money Order
or Credit Card (see below). For (U.S.) $:
CREDIT CARD INFORMATION
Type of Card:
Credit Card Number:
Exp. Date:
Signature: ______________________________
PRINT (2) COPIES OF ORDER FORM, AND FORWARD
(1) COPY ALONG WITH YOUR PAYMENT TO:
8 Commercial Street, Hicksville, NY 11801 516-931-3800 Fax: 516-931-3871
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