Order Form
Print this page, fill it out completely and send, along with cash or money order payment to:
12 Stages of Life
P.O. Box 100, Caldwell, OH 43724
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Any questions, please call 740.336.4145 or email me:
bruce@stagesoflife.com
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Book Quantity
QTY PRICE TOTAL
____ X $35 _____
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ADD $10 SHIPPING & HANDLING PER ORDER = _$10_
TOTAL AMOUNT = ___________
Please include the TOTAL AMOUNT in Check or Money Order and send to:
12 Stages of Life
P.O. Box 100, Caldwell, OH 43724
PLEASE DO NOT SEND CASH!
WE ARE NOT RESPONSIBLE FOR CASH ORDERS!
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PLEASE SHIP THE ITEM(S) INDICATED ABOVE TO:
NAME:_____________________________________________________________________
STREET ADDRESS:___________________________________________________________
___________________________________________________________________________
APT NUMBER:________________STATE:________________ZIP______________________
in case we need to contact you regarding questions or problems with your shipment, please
provide the following:
PHONE:____________________________________________________________________
EMAIL:_____________________________________________________________________