Print this page and fill in the appropriate information. Please print legibly. Credit card orders can call 1.812.332.0998 (9-5, EST) or faxed to 1.812.332.0998. Otherwise, send your order with bank check or money order payable in U.S. funds to: Beeline Publications, 916 South Ballantine Road, Bloomington, IN 47407-6526. To avoid delay, make sure this information is correct. We will confirm your order via the e-mail address you provide.
| Last Name . |
First Name and M.I. |
| Shipping Address |
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| City or Town |
State or Province |
| Postal Code . |
Country . |
| Business Phone |
Home Phone |
| E-mail Address |
How did you hear about this book? |
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| Credit Card Account No. |
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| Expiration Date |
Signature x |
| Name on Credit Card |
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| Billing Address for Credit Card |
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First Printing |
per book |
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Shipping & Handling Charge (see chart at right) |
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(Indiana residents only) |
$1.80 per book |
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