POLEBRIDGE PRESS
    Polebridge Press Books, Tapes and Back Issues Order Form

    Print, complete, and mail or fax this form to:
    Polebridge Press
    P.O. Box  7268
    Santa Rosa, CA 95407
    (707) 523-1323, toll free (877) 523-3545, fax (707) 523-1350
    e-mail
    polebridge@westarinstitute.org

Title/Issue

Price*

Qty.

Total

       
       
       
       
       
       
       
       
       
       

Subtotal

$

**Tax

$

Shipping

$

Total

$

*Westar members receive a 20% discount on books and tapes from Polebridge Press. There is no discount on back issues of The Fourth R or the Forum.

**California residents add 8% sales tax.

Shipping within the United States only:  $6.00 for first item, $.75 for each additional item. Canadians order from Scholarly Book Services, 1-800-847-9736. Australians and New Zealanders may order from Rainbow Book Agencies, 61 3 9481 6611. In the UK, Europe, Africa and the Middle East orders should be directed to Eurospan, , 44 (0)1767 604972, or, in the UK only, by calling their freephone number 0800 526830.

Ship to:

Name                                                          

Address                                                       

City                                    State                

Zip                       Country                              

E-mail                                                        

Day Phone                                                     
 

Billing:

All orders must be prepaid.

  Check or money order enclosed, payable to Polebridge Press
  (U.S. dollars drawn on a U.S. bank only)

Please bill my  Visa  MasterCard  Discover  AmEx

Name                                                          

Card Number                                                   

Security Code (Visa only)________________________
            (the last three digits in the signature block on the back of the card)

Exp. Date             Signature                              

Copyright