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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: _________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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.
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