Order Form
Please print this page, fill out the form and mail to:
Fastrak Press
6595 Castlebay Court
Highland, MD 20777-9789
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Item |
Price |
Quantity |
Total |
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By His Side - Life and Love after Stroke |
$15.95 |
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If Shipping within Maryland, add 5% sales tax |
Add Sales Tax |
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Add shipping as follows: |
Add Shipping |
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Total Enclosed |
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If you would like your book autographed, please indicate the name of the person and any special message you would like.
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Make Check payable to: Fastrak Press Please do not send cash Orders will be mailed within 24 hours |
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Your Name___________________________________________________________________
Address______________________________________________________________________
City____________________________________State_______________Zip_______________
Phone____________________________Email_______________________________________
Please provide phone or email in case of questions)
Shipping address (if different):
Name________________________________________________________________________
Address______________________________________________________________________
City____________________________________State_______________Zip_______________
Phone____________________________Email_______________________________________