ORDER FORM - JMA INFORMATION BROCHURE

Indicate the quantity desired. The brochure price is 25 cents each, plus postage
Please send a check made payable to the John More Association. Allow several weeks for delivery.

Please send me__________brochures at 25 cents each = total $__________
                                           Add postage (see rates in box) = $__________
                                                              TOTAL ENCLOSED $__________

Mail to:

Name__________________________________________________________

Street Address___________________________________________________

_______________________________________________________________

City, State, Zip____________________________________________________

Email address and/or telephone number_______________________________

Today's date_____________________________________________________

Print out and mail this order form to Cindy Leigh. ClickCindy Leigh to send an email
requesting her mailing address.

POSTAGE RATES

If ordering:
1-4 brocures, add $.80 for postage
5-10 brochures, add $1.20 for postage
11-17 brochures, add $1.65 for postage
18-25 brochures, add $2.10 for postage
26-32 brochures, add $2.60 for postage
33-40 brochures, add $3.00 for postage
41-50 brochures, add $4.00 for postage