Order Form

HANDS-ON PUBLISHING ORDER FORM

(To print out this order form, select "Print" from the "File" menu.)

Date_ Name____ Phone

Organization ________________________________ PO#_

Ship To ______________________________________________________________________

_________________________________________ Zip

Bill To (if different from ship to) ________________________________________________

_________________________________________ Zip

CC#, MC or Visa (circle one) _____________________ Expire

Authorized Signature __________________________________________________________

Print name of car holder (exactly as on card) ______________________________________

ITEM	QTY	PRICE	COST
__________________________________..............._______	_____	__________	__________
__________________________________________	_______	__________	__________
__________________________________________	______	__________	__________
__________________________________________	______	__________	__________
__________________________________________	______	__________	__________
__________________________________________	______	__________	__________
__________________________________________	______	__________	__________
__________________________________________	______	__________	__________

............................................................................................	SUB TOTAL	_________
	add 10% SHIPPING ($4.75 minimum)	_________
	add 5% tax (WI res. only)	_________
	TOTAL DUE	_________