Mail Order Form



Elizabeth Park A Century of Beauty Order Form
c/o Alicia Cornelio
327 Whitewood Drive
Rocky Hill, CT. 06067
First name:
Last name:
Organization:
Telephone:
Address:
City:
State and Zipcode:
Email:
Today's Date: mmddyyyy
Number of Hardcover Copies: ____ @ $20.00 = $_________ subtotal
Number of Softcover Copies: ____ @ $12.00 = $_________ subtotal
Shipping = 1 book: $3.00, 2 books: $3.95, 3 books: $4.95
Total payment = $_________