 Book Ordering Form
Check the box next to each book you would like to order. Scroll down to
the bottom of this page for shipping and payment info.
You can pay by credit
card with this form; you can also pay by check,
contact Wendy to get the mailing address by clicking here.
Shipping & Billing Info
* REQUIRED
First Name: *
REQUIRED Last Name
* REQUIRED
Email address: (e.g.: you@aol.com)
* REQUIRED Shipping
Address 1:
Shipping
Address 2:
* REQUIRED City/Town:
* REQUIRED State/Prov:
* REQUIRED Post./ZipCode:
Country:
Your evening phone number (with country, city, area
codes):
What is your daytime phone number?
Any Special Instructions (dedications, etc)?.
Credit Card Info
Name As It Appears On Credit Card:
Enter Credit Card Type (Visa, MasterCard, Amex, etc.):
Enter Credit Card Number (with or without dashes):
Enter Credit Card Expiration Date (month/year):
© 2006 Wendy Halperin
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