Columbia Notes - order form

Full Name:
Mailing Address: (include city, state, zip code, country)
*Your Email :	* Required

Payment by:

Cheque or Cash

PayPal Electronic Transfer

PayPal payments accepted in US dollars, Euro, or Australian dollars.
Canadian dollar payments should be by cheque or cash.

*Payment should not be made until email confirmation of your order is received.

Item	P- # and Country	Grade	Price
1
2
3
4
5
6
7
8
9
10
11
12
Postage & handling:
Insurance / registration:
	* Please note that there is a 10% discount applied to orders totaling more than $150 that include more than one note.
	* Confirmation of availability and total payment due will follow by email.

Fill a second form if ordering more than 12 items.

If you want to keep a copy of this form, please print before you submit.