Nancy Rechtman
   Home
Column Archives
Links
Reviews
For Book Clubs
       

If you do not want to place your order online,
please fill out the following form, then click the
"Print Form" button at the bottom of the page.
Mail your order to:
Publish America, Inc
P.O. Box 151
Frederick, MD 21705
Book Title

ISBN #

Quantity

Price

>
  MD Resident Tax (5%)
Shipping
Total
Bill To:
First Name
Last Name
Address
City
State
Post Code
Phone
Email
Country
Ship To:
Same as Billing Address
Ship to Name
Address
City
State
Post Code
Country
Order Comments and Special Requests

PAYMENT:
If Credit Card is selected please also complete the Credit Card Information section.
Make checks payable to: Publish America, Inc.

Credit Card Information

Card Name
Card Number
Expiration Date