HARSTAN order form (cash, check)

 

HARSTAN Digital Editions Order Form

NAME:

 

ADDRESS:

 

 

 

PHONE #:

 

Price per year/drive: 

Quantity:   ___________  x  $25.00 (price for pick-up)

                 ___________   x  $29.00 ($25.00 + $4.00 postage each if mailed.)

Total payment:  _______________

Years of HARSTAN being ordered:  (please list below)

 

 

 

NOTES:

 

 

Please print and mail with payment to:
Flora Public Library, 216 N. Main St., Flora, IL  62839    (618) 662-6553