CheckOrder Form
Books are $12.00 + $3.00 S & H
Description Qty. Price
Hoosier Record Book ______ ________
Subtotal: _____________
Shipping & Handling: _________
Order Total: ______________
Name:_____________________________________________
Address:___________________________________________
__________________________________________________
__________________________________________________
Method of Payment
Check
Money Order
Send Form To:
John Bogucki
66603 Pine Rd.
North Liberty,IN 46554