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To Order By Mail, in USA only, Print out and Complete Form Below

Please send me ______ copy(ies) of Along the Highway, by Barry W. North, at $8.00 per copy, includes shipping.

Please send me_______copy(ies) of Terminally Human, by Barry W. North, at $14.00 per copy, includes shipping.

Please send me_______ copy (ies) of In the Maze, by Barry W. North at $14 per copy, includes shipping.

I want my limited-edition chapbook(s) protected and covered with a clear 7 mil vinyl cover at an additional cost of $2 per book _____

I want my book(s) signed ___

I do not want my book(s) signed ___

Enclosed is my check (payable to Barry North) for $__________

Name________________________________________________________________

Address______________________________________________________________

City/State/

Zip__________________________________________________________________

Phone Number ___________________________________________

(in case there is a problem with the order)

Please make check or money order out to Barry North and mail to :

Barry W. North

275 Lowe St.

Hahnville, La. 70057

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