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.

 

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