TRNHA Bookstore Order Form

Theodore Roosevelt Nature & History Association

Customer Shipping Information
Name	A value is required.	Comments/Special Instructions: A value is required.
Address	A value is required.
City, State, & Zip	A value is required.
Phone #	A value is required.Invalid format.

Credit Card
(Minimum Credit Card Purchase is $10.00) ( Make Checks Payable to TRNHA)

Credit Card Type

MC Please make a selection.

Visa Please make a selection.

Credit Card #

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Expiration Date

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Card Security Code

A value is required.Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.The entered value is less than the minimum required.The entered value is greater than the maximum allowed.

Is Billing Address the same as Shipping Address? Yes No

If no, billing address here:

Shipping Charges

$0-$9.99.....$4.00	$10.00-$29.99.....$5.00	$30.00-$49.99.....$6.00
$50.00-$69.99.....$7.00	$70.00 & up.....add 10% of purchase
Ex: If your total is $85.00 your shipping is $8.50

If item:
Poster.....add $1.00 extra for a tube.
Requires a box.....add $1.00 extra.
International:
Ground..........add $ 5.00
Air.................add $10.00

Quantity	Item Description	Unit Price	Total Price
A value is required.Invalid format.Exceeded maximum number of characters.	A value is requir	A value is required.Invalid format.	A value is required.Invalid format.
A value is required.Invalid format.Exceeded maximum number of characters.		A value is required.Invalid format.	A value is required.Invalid format.
A value is required.Exceeded maximum number of characters.		A value is required.Invalid format.	A value is required.Invalid format.
		A value is required.Invalid format. A value is required.Invalid format.	A value is required.Invalid format.
		A value is required.Invalid format. A value is required.Invalid format.	A value is required.Invalid format.
		A value is required.Invalid format. A value is required.Invalid format.	A value is required.Invalid format. A value is required.Invalid format.
		A value is required.Invalid format. A value is required.Invalid format.	A value is required.Invalid format.
		A value is required.Invalid format. A value is required.Invalid format.	A value is required. A value is required.Invalid format.Invalid format.
Mail All Orders to: Theodore Roosevelt Nature & History Association PO Box 167 Medora, North Dakota 58645 (ND residents add 5% sales tax, tax must be paid on postage also) (Out of State orders: no sales tax)		Subtotal	A value is required.Invalid format.
		Postage
		Tax
		Total