Date______________________________ Purchase Order Number _________________ Name_______________________________________________________________________________ Address________________________________________________________________________________ City_________________________________________State_________Zip Code____________________
Phone Number, Area code______________Number___________________________ FAX Number, Area code_______________Number___________________________ E-mail address_____________________________________________________________________
Name of Item
1. 2. 3. 4. 5. 6. 7. 8. 9.
(ISBN) Number
Price
Postage and Handling (Priority Mail $3.20 or higher based on weight) __________________________ Sales Tax, 6% Florida Residence_______________ TOTAL__________________
If applicable, Tax Exempt Number_______________________________________State_____________ Name of Organization___________________________________________________________________ Address____________________________________________________City_______________________ Zip Code________________________Phone Number_________________________________________
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