FAX Order Form:
Print, Complete and FAX to: (866) 344-1336
or mail to: Acadinean Press, PO Box 1291, Atkinson, NH. 03811-1291
with your check payable to Acadinean Press for $20.00 USD ($14.95 + 5.05 S&H)
Name:_______________________________ Telephone ___________________
Address: _____________________________ Apartment __________________
City: _________________________________ State: _____ ZIP: ____________
Outside US: Enter Country and Code: ________________________________
E-Mail Address (For Confirmation Only): ______________________________
Credit Card: __Visa __MasterCard __Discover __American Express
Credit Card No. _____-_____-_____-_____ Expiration Date _____/20____
Last 3 numbers in signature panel on back of card: _________
(Your information will not be shared or provided to any third party)
