Order Form

E-mail address: _________________________________________

Phone number: __________________________________________

Ship-to address:

Name: _______________________________________

Street: _______________________________________

________________________________________

City / State / Zip: ________________________________

Credit Card Information (Mastercard or Visa only):

Cardholder name: ________________________________

Card Number: ___________________________________

Expiration date (mm/yy): ______ / ______

NOTE: If you choose to FAX or phone your credit card information,
please include your name and E-mail address or phone number
where you can be reached.

Title: CASTLING    Author: Rand Clifford    Price: $ 20.00 ea.
Price includes shipping / handling and sales tax where applicable.

How many copies would you like to order? ________

Special instructions or comments:___________________________

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