Natural Selections 

Purchase Book Form

 

First Name: 
Last Name:
Street Address:  (No P.O. Boxes, please.)
City:
State:    Zip Code: 
Phone to reach you: 920-555-1234
Email:
How many books do you want?  
Order 6 or more books and receive a 40% discount.

    Life is a Teeter-Totter
    How to keep your Life and Health in Balance

by Jay P. Vanden Heuvel
 
         $15.00  times  number of books = Total 
         Tax and shipping will be added to final cost.

Method of Payment:
Master Card    VISA    Discover

Credit Card No.:
Exp. Date: 
Name on Card: 

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