ATTN______________________________________________

ADDRESS___________________________________________

___________________________________________________

CITY_______________________________________________

ST_______________     ZIP_____________________________

PHONE ____________________________________________

ATTN______________________________________________

ADDRESS___________________________________________

___________________________________________________

CITY_______________________________________________

ST_______________     ZIP_____________________________

PHONE ____________________________________________

IMPORTANT: Permission to return merchandise MUST be secured in advance.
Prices subject to change without notice. The presence of a certain book or item should not be interpreted
as a guarantee of the accuracy of the doctrine or information contained.

QTY

ITEM NUMBER

CATALOG
PAGE

DESCRIPTION (INCLUDE AUTHOR, COLOR, ETC. AS APPLICABLE

UNIT
PRICE

TOTAL

[  ] CHECK, ETC. FOR $________________

[  ] MASTER CARD  [  ] VISA [  ]DISCOVER

#_________________________________

[  ]UPS          [  ]PARCEL POST

0  TO $10     $5
$10.01 to $20.00      $6
$20.02 to $40.00      $7
$40.01 to $60.00      $8
$60.01 to $90.00      $9
$90.01 to $150.00     $10
over $150.00         CALL