Book Order Form
(Print this form and mail with payment to the listed address to order your book)

 

Beyond Nam Dong

 

Mail Payment to:

Roger H. C. Donlon
2101 Wilson Avenue
Leavenworth,  KS  66048

Please remit $25.00 PLUS $5.00 postage and handling  for each book ordered.

 

Your Name:  _______________________________________________

Address:  __________________________________________________

City: ____________________________  State: _________ Zip: __________

Phone: (_____)  ________________________________

Number of Books Ordered:  ______________________

If you wish your book autographed, please indicate how you want it signed:

To Whom?  _________________________________________

Other Instructions: _________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

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If you are purchasing multiple copies and wish them mailed to friends or relatives as gifts, please detail mailing addresses and autograph information on a separate piece of paper.