GENEALOGY SECTION, KCHS
Book Order Form

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

 

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

 TOTALS
     (a)
$		  (b)

 TOTAL OF BOOKS PURCHASED (column a)  $
 KOSCIUSKO COUNTY HISTORICAL SOCIETY MEMBERS DEDUCT 10% $
 SUB-TOTAL $
 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:

E-MAIL ADDRESS

Make Checks payable to:

GENEALOGY SECTION, KCHS

P. O. Box l07l

Warsaw, IN 4658l-l07l.

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