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    SESQUICENTENNIAL BOOK ORDER FORM

    Sesquicentennial Pictorial History Book Order Form
    Name

    Address


    Shipping Address

    Phone E-Mail

    Today's date

    Number of books ordered at $25.00 each = $ ____________
    $30.00 after April 15, 2018

    Shipping and handling $7.00 for one book = $ ____________
    $10.00 for two or more books shipped to the same address
    No shipping charge if you plan to pick up the book at the museum.

    Total Paid --------------------------------------------- $ ________________

    Please makes checks payable to the Seymour Community Historical Society.
    All mail ordered books must be paid in advance.

    Send this form along with your payment to:
    Seymour Community Historical Society
    P. O. Box 237
    Seymour, WI 54165

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