Kosciusko County Historical Society
Book & Gift Shop Order Form

Please fill in the blanks on this form, then mail it along with your payment to the address below.


Shipping & Handling is 15% of total order.

 BOOK DESCRIPTION  QUANTITY  PRICE  S & H
  $
  $
  $
  $
  $
  $
  $
  $
  $
  $

  Totals:
    (a)
 (b)

 TOTAL PRICE OF ITEMS PURCHASED (column a)  $
 
 INDIANA RESIDENTS ADD 6% SALES TAX $
 TOTAL SHIPPING & HANDLING (column b) $
 TOTAL OF ORDER $

Date
Please allow 2 to 4 weeks for delivery.

AMOUNT ENCLOSED $ Check No.

NAME
ADDRESS 1:
ADDRESS 2:
CITY: STATE ZIP
PHONE NUMBER:

Make Checks payable to:

KOSCIUSKO CO. HISTORICAL SOCIETY

P. O. Box l07l

Warsaw, IN 4658l-l07l.

THANK YOU FOR YOUR ORDER...  Back to Main Book Section Go to Genealogy Book Section