Order Form
Last Name___________________ First Name________________ Mid._____
Address____________________________________
City/State/Zip________________________________
Email_____________________________________
How many copies of "A Piece of Buttter the Size of an Egg"______________ @ $14.95
Total____________ + Postage and Handling @ $3.95 per copy
Grand Total____________
Payment Type: Check_____Money Order_______Credit Card________
Card Number___________________Expiration Date__________
Card Type: Visa________Master Card__________
Signature______________________________
Mail this form to: Vera Webb, PO Box 3011, Arlington, VA 22203
Please allow 4/6 weeks for delivery.