DLJ Book Order Form by bzDalyw

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									Credit Card I

Yes, I would like to order the Complete Distinctive Landscaping Journal.
Number of Copies ____ x $45 each …………………………………………………... $ _____________
Colorado Residents add 3% tax ……………………………………………………….. $ _____________
Shipping/Handling: U.S. – $5 per Book, Canada – $10 per Book…………………. $ _____________
Total Cost.………………………………………………………………………………… $ _____________
Credit Card Type:       Visa        MasterCard          American Express     Discover
Card Account Number: ___________________________________________________________
Security Code (3 numbers on Back of Card): ______ Card Expiration Date: __________________
Name as it Appears on Credit Card: _________________________________________________
Cardholder Signature: ______________________________________Date: __________________
Street Address 1: ________________________________________________________________
Street Address 2: ________________________________________________________________
City: ______________________________State/Province: _____ Zip/Postal Code: _____________
Country: _______________________________________________________________________
Daytime Phone: _________________________________________________________________


Fax completed form to (608) 884-6308, or email to tomhatlen@charter.net.

								
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