Order Form
**PLEASE PRINT THIS PAGE TO ORDER**
|
Quantity |
Book or Product |
Price |
Total |
| "Reaching Paradise Through Intercourse: American Towns With Unique Names " | $19.95 | ||
|
|
Subtotal = |
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Please add TN sales tax if Applicable @ .0925 x Subtotal |
= |
||
|
Shipping
and handling for 1 book |
= |
+ $3.50 | |
|
@ $2.50
for each additional book |
= |
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|
Total |
$ | ||
Customer Information
| Name | |
| Ship To | |
| Shipping Address Line 1 | |
| Shipping Address Line 2 | |
| City | |
| State | |
| Zip | |
| Telephone Number |
| Suggested Personal Autograph Message |
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Please send this order form
and payment by check or money order made payable to:
Mr. Sam Drash
4541 Solomon Seal Trail
Chattanooga, TN 37415