BrendaTO ORDER AND PAY BY CHECK

Please fill out the form below, print and mail with your check to:
Jean Barlow
57 Highway Avenue
Congers, NY 10920-2519 Phone: 845-268-3170

Please make check payable to: I SEE THE WORLD©

********************************************************************************************
Name: ______________________________ Phone(s): _________________________

E-Mail Address: ___________________________________

Mailing Address: _______________________________________________________________

Number of I SEE THE WORLD Ordered _____
Braille version-___Copy/Copies @$23.95 = $ _____
Non-Braille version-___Copy/Copies @$12.99 = $ _____
(Where applicable) NY State Sales Tax (8.375%) $ _____
Shipping (1-2 Books) Add $2.00 $ _____
Shipping (3-5 Books) Add $6.00 $ _____
Shipping (5-10 Books) Add $10.00 $ _____
Over 10 Books, Shipping is Free -----

TOTAL DUE THIS ORDER $ _____

I would like the book(s) personalized by the Author ( ) Yes ( ) No
Name for personalization: __________________________
Name for personalization: __________________________
Name for personalization: __________________________

Thank you for your interest and your support!
Jean.ISeeTheWorld@hotmail.com www.ISeeTheWorld-ChildrensBook.com

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