Order Form: The Breastfeeding Atlas

Mail or Fax your order and make payment to:
Barbara Wilson-Clay
12710 Burson Drive
Manchaca, TX 78652

Fax: 512-292-7228

Voice: 512-292-7227
Email: bwc@lactnews.com

We accept: Visa/MasterCard, Personal Checks, Purchase Orders, and Money Orders
Our Tax ID number: EIN# 74-2923741

Name:___________________________________________________________________

Address (company):______________________________________________________

Address (street name & number):_________________________________________

Address (suite, room or dept):__________________________________________

City:____________________State:___________Zip:_______Country:___________

Phone: ________________________ E-Mail: ________________________________

Credit Card Type (Visa or MasterCard only):_____________________________

Credit Card # or Purchase Order Number:_________________________________

Credit Card Expiration Date:____________________________________________

Credit Card 3 digit security code on back:______________________________

Signature:______________________________________________________________

Number of Copies: __________________ at $59.00. Total: $________________
40% discount on orders of 5 or more

Sales Tax: TX or PA only. Texas (8.25%), Pennsylvania (7%) _____________

U.S. Shipping and Handling: $9.00 for a single copy ____________________
Canada Shipping and Handling: $12.00 for a single copy

Total Enclosed: $_____________________________________________________

Preferred shipping method: ____ UPS or ____ United States Postal Service

Please inquire concerning international shipping rates and bulk orders