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----------------------------------------------------------------------------------------------------- FAX this form to 1-267-543-4908 ___ Enclosed is my check, money order or credit card order for $49.00 - plus $13 S&H ($23 foreign orders). These posters will rolled and shipped in long tubes. They're not folded up. Totalling $_____________.00 Charge my (Note: You can use more than one card to complete this order): Visa, Mastercard Card Number:_____________________________________________ Exp. Date:______________ Signature: __________________________________________ Print Name: _______________________________________________________________________ Address 1: _________________________________________________________________________ Address 2: _________________________________________________________________________ City: ______________________________________ State: __________________________________ Zip Code: ______________________________ Country: __________________________________ Date of Birth: _____________________________________ Telephone: _______________________________________________ Fax Number: _____________________________________________ E-Mail: __________________________________________________ How did you find us: __________________________________________________
Or Mail This Order Form To: Palko Publishing You may call our 24-Hour Order Line at: 1-877-375-4163 to place your order.
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