FAX and MAIL Order Form
Choices: 1) fill in the blanks online, then print page; or 2) print out this page and fill in by hand

* Date

* First and Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Payment may be made with either a personal check, an authorized bank money order, credit card, or debit card. If using a credit/debit card, please fill out the following card information. If paying with check or money order, please make payable to KohlQuest.

* Name on Card

* Card Type

* Credit Card Number

* Expiration Date (mm/yy)

* 3-Digit or 4-digit Security Code (last 3 numbers on the signature strip on back of MC, Visa or Discover credit cards; 4 numbers on front and right of AMEX card)

* Number of Books Ordered

* Subtotal Book Order (number of books ordered x $24.95)

* Select the standard USPS Shipping Rate that matches the total amount of your order. All dollar figures are USD. For larger orders, call 828 288 0730 for special shipping rates and/or arrangements.

$24 -$60 (7.95 s/h)

$61 - $100 (9.95 s/h)

$101 - $199 (11.95 s/h)

$200 - $299 (14.95 s/h)

* ORDER TOTAL including shipping and handling

Ship To Address: (if different than above)

First Name

Last Name

Address

Address Line 2

City

State

Zip

Thank you for your order!

DIRECTIONS:

1. Print out this order form. If you don't have a printer, write all pertinent order information on a plain sheet of paper and mail or fax it with your payment.
2. Fill in all lines. Be sure all information you provided is accurate. Check for any misspellings or typos.
3. Be sure to include the correct shipping and handling information (see listing above) before entering you final TOTAL order amount.

FAX THIS ORDER FORM WITH CREDIT/DEBIT INFORMATION TO: (828) 286-9786
MAIL THIS ORDER FROM WITH CHECK OR MONEY ORDER PAYMENT TO:
KohlQuest
3271 Polk County Line Road
Rutherfordton, NC 2813
USA

HAVE QUESTIONS? Call KohlQuest at (828) 288-0730 between 9:00 AM and 5:00 PM ET

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