ORDER FORM

To order, call 708-488-0100; fax form to 708-488-0101; or mail to Maiden Name Press, P.O. Box 2249, Oak Park, IL 60303

Please send me the following:

____ ¡Cocina! A Southwestern Kitchen $16
____ ¡Cocina! A Southwestern Kitchen $16
SUBTOTAL: $__________
SHIPPING CHARGES:
$5 for the first poster, $1.95 per item thereafter.
$__________
SALES TAX:
Illinois residents, please add 9% sales tax.
$__________
TOTAL: $__________
Please send to:

______________________________________
Name
______________________________________
Address (no P.O. box, please)
______________________________________
City, State, ZIP
______________________________________
Telephone/Fax

Method of payment:

______Check or money order, made payable to Maiden Name Press

______VISA ______Mastercard ______American Express

______________________________________
Name on Card
______________________________________
Credit card number

Exp. date ________

______________________________________
Signature