Mail Order
Form
Columbia-Greene Humane Society/SPCA
One of a Kind Cookbook
Name________________________________________________
Address______________________________________________
City_____________________ State_______ Zip______________
Phone ( )_____-________
E-mail________________________
Ship to address if different from above or ship second book
to:
Name________________________________________________
Address______________________________________________
City _____________________State _______Zip______________
Phone ( )_____-________
From________________________________________________
Number of Books Ordering _____________
Total for Books @ $19.95 each
$___________
Sales Tax ($1.55 per book) NY State Residents $___________
Total Shipping and Handling at $5.00 per book $___________
Grand Total $___________
Method of Payment
Check
enclosed payable to CGHS/SPCA for
$ ___________
Credit Card
MasterCard or Visa
Name as it
appears on credit card:
_____________________________________________________
Address______________________________________________
Phone ( )______-___________
Credit Card Number_____________________________________
Expiration Date_______________
Total amount charged to credit card
$_____________ Signature_____________________________________________
Please mail to: CGHS/SPCA,
or