ORDER FORM
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Name: |
___________________________________________ |
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Address: |
___________________________________________ |
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City: |
___________________________________________ |
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State: |
___________________________________________ |
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Zip: |
___________________________________________ |
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Phone (Day): |
___________________________________________ |
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Phone (Evening): |
___________________________________________ |
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Email: |
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Send to (if different from above):
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Name: |
___________________________________________ |
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Address: |
___________________________________________ |
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City: |
___________________________________________ |
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State: |
___________________________________________ |
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Zip: |
___________________________________________ |
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Phone (Day): |
___________________________________________ |
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Phone (Evening): |
___________________________________________ |
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Email: |
___________________________________________ |
Order:
|
Issue |
Quantity |
Unit Price |
Member Price |
Amount |
|
Vol.1 No.1: Summer 2001 |
_____ |
x | $4.95 |
$4.20 |
= ______ |
Vol.1 No.2: Fall 2001 |
_____ |
x |
$4.95
|
$4.20 |
= ______ |
Vol.1 No.3: Winter 2002 |
_____ | x |
$4.95
|
$4.20 |
= ______ |
Vol.1 No.4: Spring 2002 |
_____ | x |
$4.95
|
$4.20 |
= ______ |
Vol.2 No.1: Summer 2002 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.2 No.2: Fall 2002 |
_____ |
x | $4.95 |
$4.20 |
= ______ |
Vol.2 No.3: Winter 2003 |
Not |
Available |
|||
Vol.2 No.4: Spring 2003 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.3 No.1: Summer 2003 |
Not |
Available |
= ______ | ||
Vol.3 No.2: Fall 2003 |
_____ |
x | $4.95 |
$4.20 |
= ______ |
Vol.3 No.3: Winter 2004 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.3 No.4: Spring 2004 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.4 No.1: Summer 2004 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.4 No.2: Fall 2004 |
_____ |
x | $4.95 |
$4.20 |
= ______ |
Vol.4 No.3: Winter 2005 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.4 No.4: Spring 2005 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.5 No.1: Summer 2005 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.5 No.2: Fall 2005 |
_____ |
x | $4.95 |
$4.20 |
= ______ |
Vol.5 No.3: Winter 2006 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.5 No.4: Spring 2006 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.6 No.1: Summer 2006 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.6 No.2: Fall 2006 |
Not |
Available |
= ______ | ||
Vol.6 No.3: Winter 2007 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.6 No.4: Spring 2007 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.7 No.1: Summer 2007 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.7 No.2: Fall 2007 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.7 No.3: Winter 2008 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.7 No.4: Spring 2008 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.8 No.1: Summer 2008 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.8 No.2: Fall 2008 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.8 No.3: Winter 2009 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.8 No.4: Spring 2009 |
Not |
Available |
= ______ | ||
Vol.9 No.1: Summer 2009 |
_____ | x | $4.95 |
$4.20 |
= ______ |
Vol.9 No.2: Fall 2009 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.9 No.3: Winter 2010 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.9 No.4: Spring 2010 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.10 No.1: Summer 2010 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.10 No.2: Fall 2010 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.10 No.3: Winter 2011 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.10 No.4: Spring 2011 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.11 No.1: Summer 2011 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.11 No.2: Fall 2011 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.11 No.3: Winter 2012 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.11 No.4: Spring 2012 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.12 No.1: Summer 2012 |
_____ | X | $4.95 |
$4.20 |
= ______ |
Vol.12 No.2: Fall 2012 |
_____ | X | $4.95 |
$4.20 |
= ______ |
| Subtotal | = _________ | ||||
| Shipping & handling | = _________ | ||||
| TOTAL | = _________ |
made payable to the Archives Partnership Trust.
|
ACCOUNT NUMBER: |
_______________________________ |
|
EXPIRATION DATE: |
_______________________________ |
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CVV # (last 3 digits on back of card on signature line): |
_______________________________ |
|
SIGNATURE: |
_______________________________ |
| Print and mail this form to: | Or fax form to: |
| Archives Partnership Trust Cultural Education Center, Suite 9C49 Albany, NY 12230 |
518-473-7058 |
| Shipping & Handling | ||
| If your order totals | Add | |
| Up to $15 | $1.95 | |
| $15.01 to $30 | $3.95 | |
| $30.01 - $70 | $5.95 | |
| $70.01 - $100 | $9.95 | |
| $100.01 - $150 | $10.95 | |
| $150.01 - $200 | $12.95 | |
| Over $200 | $14.95 |
