Order Form

ORDER FORM

You may purchase copies of this book from your local bookstore or from:

Postal Orders: Paloma Blanca Press, PO Box 1751, Taos NM 87571

Toll-free fax orders: 877-520-4890

Order using PayPal:

Email Orders: pbp@PalomaBlancaPress.com (copy this form & paste into email)

Please send ____ copies of Fifty and Beyond: New Beginnings in Health and Well-Being to:

Name: ______________________________________________________

Address: ____________________________________________________

City: _______________________ State/Province: __________________

Zip/Postal Code: ____________ Country: ________________________

Telephone: ________________________________________

Email address:(for confirmation of order) _________________________

Sales tax: Please add 7% for books shipped to New Mexico addresses.

Shipping by air:

U.S.: $3.95 for first book and $2.00 for each additional book

International: $8.75 US for first book; $4.75 US for each additional book

Signed copy (no extra charge) Autograph to read (please print legibly!):

____________________________________________________________

Payment:
# of books___ x $14.95 = _______ + tax (NM res. only) =_________
+ shipping_________ = total $______

__ Check (payable to Paloma Blanca Press) __ Credit card:

__ Visa __ MasterCard __ AMEX __ Discover

Card number: _________________________________________

Name on card: __________________________ Exp. Date: ________

Signature: ________________________________________

Print this page for mail or fax orders.