R O B E R T C O L L I E R P U B L I C A T I O N S, I N C.
Please print as many copies of this order form as you need. Fill it out
and send, with appropriate payment, to:
Robert Collier Publications
2716 Joseph Ave. #1
Campbell, CA 95008
USA
Phone: +1(408)540-6573
Fax: +1(408)559.1536
Your name: ___________________________________________
Address: ___________________________________________
___________________________________________
City, State, Zip: ___________________________________________
Ship to: ___________________________________________
(if different)
___________________________________________
___________________________________________
Telephone number: (______) ______ - ________
E-mail address: ___________________________________________
Please make the appropriate selection:
_____ I am paying by enclosed check
Amount enclosed: $ _________________
_____ I am paying by credit card.
Card #: ________________________________
Expiration date: __________________
B O O K S E L E C T I O N S
Book Title (& Edition, if necessary) Individual Number Subtotal
cost
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
_______________________________________ $ _________ x _____ = $ _________
There are additional charges for shipping
outside the US, and for anything other than
Media Mail Shipping: $ _________
Washington residents, please add 8.3% sales tax Subtotal: $ _________
Total: $ _________
T H A N K Y O U F O R Y O U R O R D E R !