Mail or Fax this Order Form to:
The Back Pack
PO Box 125
Ernul, NC 28527
(252) 244-0728

Name __________________________________________ Date ______________2011

Address _______________________________________ Phone __________________

City ______________________________________ State _______ Zip _____________

Qty

Publisher

Title/Description

 Price Each

Total
         
         
         
         
         
         
         

 Credit Card Information    

 Number_____________________________________

 Expires_________ Signature_____________________
  Please circle one:

       Discover                 Master Card            Visa


Sub-total _______________

S&H  _______________

Sub-total _______________

NC Res. - 7.75 % Sales tax_________

Total  _______________
.


Office use:

 Shipping Date _________BO shipping date_________

 App # _____________Check #________B #_______


Shipping & Handling Charges:
    10% of Sub-total
   $4.00 Minimum
 
We ship by US Postal Service or UPS

                                       The Back Pack Home Page 

Site Map