Griefnet Order Form:
Flying with the Angels

by Timmaris Hastings

(Fields with an asterisk * must be filled in.)

First name:
Middle Initial:
*Last name:
*Street:
Suite/Apt #:
*City:
*State/Province:
*Zip/Postal Code:
*Country:
Telephone:
Fax:
*E-Mail:
*Number of copies:
*Total: (# of copies x $5.00)
*Shipping and Handling:
first tape: $2.50
each additional tape: $1.00
$200 to $400=$7
$400+ Call.
IN sales tax: 5%
*Total:
*I wish to pay by:
Check Credit Card
Card Number:
Expiration Date:
Name that appears on the card:


Signature:__________________________________________________


If you prefer you can print this form out. Fill in all the necessary fields and choose Print from the File menu on your browser and mail it with your payment or FAX it to Grief Net at the following address:

Mail to:
GriefNet
PO Box 3272
Ann Arbor, MI, 48106-3272
USA

FAX:313-761-1960

When printing this form out, please make sure to sign it at the bottom if you plan to pay by Credit Card.
All payments should be in US funds.
Thank you.

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