GND Poetry


Printable Order Form
 
Please fill in your details here
Necessary items are marked with an asterisk*


*Date: ________________________

*Full Name: __________________________

*Delivery Address: __________________________

*City: _________________ *State:____________

*Zipcode: ___________

*Home ph: (    ) _______________

Work ph: (    ) _______________

Cell: (    ) ____________________

Fax: (    ) ____________________

Email address: _____________________ @ ___________

Poem Title: __________________________________


*There will be an additonal $2.00 fee for shipping and handling

Total Price: $_________________


Special Instructions / Comments / Requests:

____________________________________________

____________________________________________

____________________________________________

____________________________________________



Please allow up to 15 days for delivery.


Please send or fax order form to:
GND Publishing
P.O. Box 33288
Indianapolis, IN 46203