_______________________________________________________________________
Name (Please Print)
_______________________________________________________________________
Address
_______________________________________________________________________
City, State, Zip
Send ____________ book(s) @ 7.50 each = Subtotal: $__________
Kansas residents add 6.8% sales tax $__________
Total Amount Enclosed: $__________
Note: Any contribution above the price of the book(s) is tax-deductible.
Payment Method:
_____ Check or Money Order
_____ Credit Card (see below)
Credit Card Information:
____ Visa ____ MasterCard
Card #: ________________________________________________________
Expiration Date: __________________________________________________
Name on Credit Card: _____________________________________________
Signature:_______________________________________________________
Phone: _________________________________________________________