To order directly from us, please print this form and send check or money order
made out to Chase Publishing to the address below:
Chase Publishing
P.O. Box 1200
Glen, NH 03838
Please list the number of copies you are ordering, your address, and the address to which they are to be mailed (if different from your own). Be sure to add your telephone number and e-mail in case we need to contact you about your order. BACK TO CHASE PUBLISHING
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Order Form

 Qty. Price Total Amount
The Litter of Leaving: Collected Poems @14.95 per copy      
Cafe Chimes Cookbook @ $19.95 per copy      
Moments @ $9.95 per copy      
Undertones @ $10.95 per copy      
The Head of the Bull @ $12.95 per copy      
Shipping & Handling: (See Shipping & Handling Rates below)  
TOTAL ENCLOSED
Payment Method: Check Money Order PayPal

Standard Shipping & Handling Rates
1 Book Add $3.50
2 Books Add $5.75
3 Books Add $8.00
Additional Books Add $2.25 for each additional book.

Your Address: (Please print clearly)     Gift Address: (Please print clearly)
Name:

Name:
Street: Street:
City: City:
State:                         Zip: State:                         Zip:
Telephone #: (         ) Telephone #: (         )
E-mail: E-mail:
Number of copies to this address: Number of copies to this address:

Chase Publishing
A Division of A.C. Chase Asociates LLC
P.O. Box 1200
Glen, New Hampshire, 03838
Tel: 603-383-4166
Fax: 603-383-8162
Email: achase@chasepublishing.com
www.chasepublishing.com
copyright © 2003 by Chase Publishing