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 = $_________ |