THE CHARLES PRESS, PUBLISHERS
Post Office Box 15715 Philadelphia PA 19103  Phone: 215-561-2786  Fax: 215-561-0191

Date of Order: _________________________________________________________________________________________

Purchase Order Number:_________________________________________________________________________________


BILLING INFORMATION: (If paying with a credit card, use the address to which your statement is sent)

Company: ___________________________________________________________________________________________

Your Name:
___________________________________________________________________________________________

Address: _____________________________________________________________________________________________

City, State, Zip, Country: ________________________________________________________________________________

Billing Phone (must include): ________________________________ Billing Fax: ___________________________________

Email: _______________________________________________________________________________________________


SHIPPING INFORMATION
: (No post office boxes please)

Your Name and/or Company Name:________________________________________________________________________

Address (include dept., apt., etc): _________________________________________________________________________

City, State, Zip, Country: ________________________________________________________________________________

Shipping Phone:________________________________________________________________________________________

 

Book Title Qty Price Total
    $ $
    $ $
    $ $
    $ $
SELECT YOUR METHOD OF PAYMENT:

Purchase Order Money Order Check (US only)
  Subtotal   $
  Shipping Rates  $
  Tax     $
 

TOTAL   

$


All prices subject to change without notice.