|
|
Name |
_____________________________________________________ |
Address |
_____________________________________________________ |
City/Town |
_____________________________________________________ |
Prov/State |
_____________________________________________________ |
Postal Code/ Zip |
_____________________________________________________ |
Country |
_____________________________________________________ |
Phone |
_____________________________________________________ |
e-mail |
_____________________________________________________ |
# of Copies (9 or less) |
_________________ |
x |
$20.00 = |
_______________________ |
# of Copies (10 or more) |
_________________ |
x |
$16.00 = |
_______________________ |
|
|
|
Shipping |
_______________________ |
|
Total Amount: |
$ ___________________ |