Please type where indicated, your name, your postal mailing address, telephone numbers and payment information.
Name
Street Address
Mailing Address (if different)
City
State
Zip Code
E-mail Address #1
E-mail Address #2
Daytime Telephone Number
Evening Telephone Number

If you want your book(s) returned by e-mail file attachment; In what format do you want the file(s) returned to you? ( i.e. What word processor do you use? ) Leave in Word Perfect .rtf (rich text format)

If you want your book(s) returned on 3 1/2" disk; In what format do you want the disk returned to you? ( i.e. What word processor do you use? ) Leave in Word Perfect .rtf (rich text format)

Payment Method:
I will pay for my book(s) by:
Credit Card
Mailing In My Check, Money Order or Cashier's Check

Return mail my book by:
e-mail attachment to the following e-mail address:

Overnight Express Shipping ($20 surcharge)
1st Class U.S. Postal

For payment by credit card, please complete the information below. This will enable us to ship your book immediately.

Checking Account Debit Card (MasterCard & Visa)
*You may use your MasterCard or Visa checking Account Debit Card by completing the following credit card information. This will allow your checking account to be debited and shipping to be done immediately.

Which Credit Card Will You Be Using?
MasterCard
VISA
Credit Card Number
Expiration Date
Card Holder's Name (as it appears on the card)
Street Address (Card Holder's)
City/State (Card Holder's)
Zip code [Card Holder's]

$20.00 $20 Overnight Express Shipping surcharge)

I understand that by checking this box, I will be responsible for all collection fees, attorney fees, court costs, and any other costs associated with the collection of my payment, should it become necessary.