| Name:____________________________________________________ Shipping Address:__________________________________________________ ________________________________________________________________ Phone:__________________________ Payment Method: (circle one) [Credit Card] [Check] [Cash] [Cashiers Check] Shipping Method: (circle one) [Priority (2-3 days) $5.00 extra] [Media Mail (allow 1 - 3 weeks): Free] [International shipping; contact Customer Service for quote. Click here: CustomerService@Back40Group.com Book Titles & Price: | Book Title | Price | | 1) | $ | | 2) | $ | | 3) | $ | | 4) | $ | | 5) | $ | | 6) | $ | | 7) | $ | | Missouri residents add 5.225% sales tax Shipping Handling (orders less than $25.00) add $4.50 | $______________ $______________ $ | | Order Total | $ | Billing Address: (leave blank if same as shipping address) ___________________________________________________________________________________________ ___________________________________________________________________________________________ Credit Card Number:______________________________ Credit Card Type:__________________ Credit Card Expiration Month/Year: ___/___ Name as it appears on card:______________________________________________ Please Mail this form to: Back40Books.com
Mail Order Department
Nature's Pace Sanctuary
Hartshorn MO 65479 | 
