FUND-RAISER ORDER FORM for Option 1
100 Ways to Strengthen & Unify Our Country (ISBN #0-9644064-9-7)

Organziation doing fund-raiser: _______________________________________

Please complete a separate order form for each shipping address.

Please make checks payable to ________________________________________

Thank you for your order!

 # Books to this address  
Price each x $ 9.95
Subtotal = $
Sales tax ( ______%) + $
Shipping for first book + $.99
Shipping for each additional book to same address (25¢ each) + $
 Total = $

Ordered by:

Name: __________________________________________________________

Street: ________________________________________ Apt. #_____________

City: __________________________ State: _________ Zip: _______________

Phone: (_________) ___________ - ______________________

E-mail Address: ________________________@____________________.com

If you want your order shipped to a different address, please fill out the next section.

Ship to (only if different than information above):

Name: __________________________________________________________

Street: ________________________________________ Apt. #_____________

City: __________________________ State: _________ Zip: _______________

Phone: (_________) ___________ - ______________________

E-mail Address: _______________________@______________________.com

This form is to be submitted by organization doing fund-raiser, along with summary sheet, payment, and proof of status.