ORDER FORM

NAME:_____________________________________________________

ADDRESS:__________________________________________________

CITY:_________________________ STATE:________ ZIP:__________

PHONE:___________________________

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TITLE__________________________NUMBER_____PRICE_________TOTAL

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____________NJ sales tax 7 %______________________________________________

__________Postage/Handling_______________________________________________

__________TOTAL ENCLOSED___________________________________________

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Postage & handling charge: 1 book... $250; each additional book...$0.50

BARNEGAT LIGHT PRESS

P.O. Box 607, 3959 Route 563

Chatsworth, NJ 08019-0607

Phone: (609) 894-4415 Fax: (609) 894-2350