Fax Order Form (for U.S. orders)

To: W. W. Norton Order Department, Dept. I
Keystone Industrial Park
Scranton, PA 18512
FAX# 1-800-458-6515 
Ship to: 

Name ___________________________________________________________


Address ________________________________________________________


City ___________________________________________________________


State/Province _________________________________________________


ZIP/PC ______________________ Phone ____________________________
============================================================================================== ISBN Title/Author Qty Price
0-393-30565-1 West of the Imagination/Goetzmann _____ $17.95
_______________ _______________________________________ _____ __________
_______________ _______________________________________ _____ __________
_______________ _______________________________________ _____ __________
_______________ _______________________________________ _____ __________

Subtotal ____________
*Residents of CA, NY, PA, and IL Sales Tax* ____________
must add their local sales tax. Order total ____________

Method of payment: ___ VISA ___ MasterCard ___ American Express ___ Check/money order

Acct. _______________________________ Exp. Date _______ Signature ___________________________

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