Please provide the following contact information:

Name
Title
Organization
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
FAX
E-mail

Please provide the following ordering information:

Publication Order Form
QTY	Description	Cost	Total
	Sample copy - A Smart Move (business customers only)	N/C	$0
0 1 2 3 4 5 6 7 8 9 10	Bulk pkg.'s of 25 copies of A Smart Move @ $25ea.	$25ea.	$0 $25 $50 $75 $100 $125 $150 $175 $200 $225 $250
	Opportunity Knocks & A Smart Move - 1 copy of each	$10.00	$0 $10
	Sub-Total
	Shipping & Handling		$4.50
	GST - add 7% (Canadian orders)
	Total (to be invoiced)

	BILLING
Purchase order #
Account name

	SHIPPING (if different from above)
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country