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PRINT THIS FORM OUT AND COMPLETE TO PAY BY CHECK Please Print Clearly RETURN TO :(Make checks payable to Joseph Fagan) JOSEPH FAGAN - PO BOX 306 - NETCONG, NJ 07857 YOUR NAME ____________________________________________ ADDRESS ______________________________________________ STATE _________ ZIP CODE _________ West Orange $ 21.99 Eagle Rock Reservation $ 19.99 MAILING COST IS $ 4.95 FOR ONE OR BOTH FLAT RATE PRIORITY Mailing Cost $ 4.95 NJ RESIDENTS PLEASE ADD 7% SALES TAX $ _______ TOTAL ENCLOSED $ _______ All books will be signed by author only if a preference is indicated below: _____ Personalized to person above. _____ Signed but not personalized. _____ Special instructions ( Please indicate below). |