Mail In Order Form

MAIL-IN ORDER FORM

At one time we had listed all our items, but as our inventory grew and after adding a secure shopping cart and the option of making PayPal payments, we abandoned the list. However, there are still some who prefer sending information by mail/, rather than via the Internet. If this is your choice, you can simply write everything out or print and use this form.

1. Fill in all the information (including your signature at the end).
2. Credit card orders and PayPal orders can be submitted by mail.
3. Or, you can mail this form, with the appropriate check or money order to: PEC Publishing; 429 Grand Ridge Drive; Howard, OH 43028-8409

4. You also have the option of simply writing out the item or items that you want and sending your selection by e-mail to Dr. Birch. Your e-mail should contains your name, address, age, credit card type (VISA, MasterCard or American Express), the credit card numbers and expiration date. You can also use your PayPal Account. PayPal payments using the secure shopping cart are quick and easy. However, if you wish to order by mail, once the order is received you will be e-mailed a PayPal Invoice.

If you choose to use the form, print it out and fill in the indentifying information below.

WE WILL AUTOMATICALLY SHIP BY PRIORITY MAIL.

Special rates are calculated for shipments outside the United States apply.

Books. DVDs or videos containing visually explicit material will not be mailed to countries with unknown custom laws.

Payment may be by check, MasterCard, VISA. or American Express

Ohio residents must add 6.5% State Sales Tax. I am an Ohio Resident.

PRINT YOUR INFORMATION CLEARLY

Name:

Address:

City:

State/Province:

Country:

ZIP/Postal Code

Age:

E-mail address (Helpful if there is a question):

Phone Number (Helpful if there is a question):

Credit Card type (VISA/MC/AmericanExpress)

Credit Card Expiration Date

Credit Card number

I certify that I am at least 18 years old:

(signature)

Credit card charges will appear as being paid to PEC PUBLISHING (or R. W. Birch)
Your information will never be sold or traded with another individual or company. You will never be called or receive any e-mail or mailed literature from us.

LIST THE ITEMS YOU WISH TO ORDER WITH PRICE. IF PAYING BY CHECK, CALCULATE POSTAGE. FIGURE $6.00 FOR THE FIRST ITEM AND $1.00 FOR EACH ADDITIONAL ITEM. CHECKS WILL NOT BE ACCEPTED FROM PERSONS OUTSIDE THE UNITED STATES. INTERNATIONAL MONEY ORDERS WILL BE ACCEPTED, BUT SHIPMENT WILL NOT OCCUR UNTIL THE BANK HAS VERIFIED PAYMENT.