Online Book & Tshirt Reservation Form

Book of Days Book of Days

NOTE: This form is ONLY to be used to reserve items that will be picked up on Sunday, Nov. 12, 2006 at the Story Circle Network's benefit book signing. See our Book Signing flyer for more information. Items will NOT be mailed! Payment may be made by check or cash at the event, or by credit card prior to the event (using the PayPal.com website—see link on the next page, after you submit the form).


Items to Reserve: (please enter the quantity)

Name:
Street Address:
City:
State/Province: (select "n/a" for non-US, non-Canadian residents)
Zip Code:
Country:
Email Address:
Phone Number:


Last updated: 10/31/06