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Or, please fill in this form, print it and fax it to us, or fill in, print and mail. Or email your order to us. (To do this, fill in the form, then highlight the whole document with your mouse, then copy this information and paste it into an email message and email your order to us.)

Please allow two weeks delivery time. Thank you for your order.

Missouri Gold Booksellers Order Form

A Division of Pebble Publishing, Inc.

Fax your order to (573) 698-3108      Or mail to: P.O. Box 2     Rocheport, MO 65279

Phone: (573) 698-3903     Email: pebblepublishing@gmail.com

Billing Information: Please print clearly.

Billing Contact: 
Telephone:
Address:
City and State: Zip:

Please Select Payment Type:

Check Enclosed. Check Number:

Credit Card:          Visa          MC          Discover          Am. Express

Credit Card Number:                                                      Exp. Date:

Please Bill Me. Purchase Order #

(For wholesale, corporate & tax exempt accounts only.)

Shipping Information (If Different Than Above):
Shipping Contact:
Telephone:
Physical Address:
City and State: Zip:

CAT. #

QTY.

BOOK   TITLE

PRICE

TOTAL

ATTENTION SCHOOLS & LIBRARIES:

Accounts are billed Net 30. Please send Pebble Publishing, Inc. your Mo. Dept. of Revenue Sales/Use Tax Exemption Form 149.

q Please send us Form 149.

We’ll fill it out & mail it back in.

Subtotal

Applicable Discount (If Any)

Missouri Sales Tax (7.05%)

(In-State Missouri Orders Only.)

Shipping:

7% of order total if order is less than $250.

5% of order total if order is more than $250.

ORDER TOTAL

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