White Buck Publishing

Mail Order Form

Please print, complete, and forward this form with your check or money order to:

White Buck Publishing
1143 Highway 99
Waynesboro, TN 38485-3014

In the event that you have any questions, and/or require additional information, please feel free to contact us:


Voice/Fax: (931)722-3586
     E-mail: White Buck Publishing


Quantity            Description                  Unit Price     Total Item Price

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                                              Order Subtotal:   ________________
																							
                                                    Shipping:   ________________
																
                     Tennessee Residents Add 9.75% Sales Tax:   ________________
										 
                                                       Total:   ________________

Customer Shipping/Contact Information:

Name: ______________________________________________________
Company Name: ______________________________________________
Address: _____________________________________________________
City: _______________________________________ State: _______________________
Zip Code: ________________ *Telephone: ________________ *Fax: ________________
*E-mail: _____________________________

* Optional information. Will be used only in the event that a question arises in respect to your order. (See our "Privacy Policy").

Special Instructions/Autograph Requests/Dedication:

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No portion of this work may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, downloading, printing, and/or recording, or by any information storage or retrieval system without the prior written permission of the publisher.