9100 Artesia Blvd • Bellflower, California 90706 • Ph:562-920-1312 • Fx: 562-920-3077 • derusgal@aol.com

Book Order Form to Print  and Mail or Fax

TITLE: PRICE:
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NAME:______________________________________________________________        SUB TOTAL: _________________
C/O:_________________________________________________________________ SALES TAX: _________________
ADDRESS: ____________________________________________________________  SHIPPING: _________________

CITY: ___________________________________ STATE: _____ZIP: ______________

WORK PHONE #: ____________________________________ EXT#: ___________

CELL #: _____________________________ DAYTIME#: ______________________________

BALANCE: _________________

 

CHECK/MONEY ORDER ENCLOSED: #_____________________ CHARGE TO VISA/MASTERCARD: ____________________  

CARD NUMBER: ____________________________________________CCV (security code) ______________     EXP. DATE: ___________________

CARD ISSUED TO: ______________________________________________ SIGNATURE:________________________________________________

California residents must include 9% sales tax. Shipping & handling is from $6.00 to $11.00 for the first book and $3.00 to $6.00 for each additional book depending on the weight. Please call for quote. We use Priority Mail service for all orders - for orders outside of the United States, call or fax for shipping quote. Orders are shipped daily, Tuesday - Friday. If your order is received damaged, save the packaging, contact the delivering post office and notify us immediately for return instructions.