Dave's Book Order Form  (thank you for buying direct)

"And Then We Laughed"

isbn: 978-1-4500-2118-0

Soft cover copy (Ask me about the hard cover)

• First Name:                                   Last Name:                                             

• Phone No: (____)  ____ - ______ Night No:  (____) ____ - ______ 

• Address:                                                        

• City:                                                State:  __     Zip: _____-_____                    

• Country:                                                   

• Credit Card Type:  Visa    Master Charge  

• Credit Card Number:   ____ - ____ - ____ - ____                                         

• Security code:        ___         

• Expiration Date:     __/__/____              

• Name on Card:                                            

• Zip Code on Card:  _____                      

• Number of Books:  _____  X $18.00 = $ _____                         

• Email Address:                                                 

Copy or print this form and insert the required info and mail the form with check or money order to:

Dave Gustafson
Po Box 5323
Modesto, CA 95352

(209) 529 - 1026 Dave's Appliance Svc. or (209) 575 - 1770 FAX (daytime, Pacific Std Time, only)

You may also Email this form for a Credit Card order to: svngrace@prodigy.net

For PayPal payments send a payment and copy of this form via email: svngrace@prodigy.net to
Make PayPal payment.

Shipping included for this promotion price and is subject to an expiration. 1/27/2010 so hurry. USA only.
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