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Date:
Name: ____________________________
Mailing Address: ____________________
__________________________________
__________________________________
__________________________________
Telephone Number: (____)
____-_______
Email Address: _____________________
(if you wish
notification of payment receipt)
Number of copies BEYOND
NOOTKA: _____ x $32.50 + $4.50 Postage & Handling
in Canada. International orders please email for rates.
TOTAL: ______________
NOTE: Cheques/postal
orders must be made payable to Lindsay Elms.
If you have special
requests re: signing, please note below:
______________________________________
______________________________________
Mail
to:
Lindsay
Elms
2069 Galleon Way, Comox
British Columbia Canada V9M 3Z2
If you would like further information, please
email me or Tel: (250) 792-3384
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