Print this form and then FAX to number below.

                                                 LAM Bookmark Ordering Form
 

Mail or FAX your order and make payment to: We accept:
Barbara Wilson-Clay Visa/Mastercard
12710 Burson Drive Personal Checks
Manchaca, TX   78652 Purchase Orders
512-292-7227 Fax 512-292-7228 EIN# 74-2923741
bwc@lactnews.com
                                     

Name:_____________________________________________________________

 

Address:___________________________________________________________

 

Dept. (Room #):_____________________________________________________

 

City:_________________________________________ State: _____Zip:_______

 

Phone: ________________________ E-Mail: _____________________________


Credit Card or Purchase Order Number:__________________________________

 

Credit Card Type:____________________________ Exp. Date:_______________

 

Signature:__________________________________________________________
 

Number of Packets: _____ at US $25.00                                                     $_________

Sales Tax: TX or PA residents only.
Texas (8.25%)or Pennsylvania (7%)                                                            $_________

U.S. Shipping and Handling: $7.00 for 1 to 3            
                                                       $9.00 for 4 to 10
                                                     $12.00 for 11 to 20                                        $_________

 

Total Enclosed                                                                                                   $_________

Please inquire concerning international shipping rates and bulk orders.