Order Form

Home

Ordering Instructions

Name_______________________________________________________________________________

Shipping Address____________________________________________________________________

City, State, Postal Code_______________________________________________________________

Country_____________________________________________________________________________


Name_______________________________________________________________________________

Billing Address_______________________________________________________________________

City, State, Postal Code_______________________________________________________________

Country_____________________________________________________________________________

Phone / e-mail_______________________________________________________________________

Code Title Price # Total
         
         
         
         
         
         
         
         
         


Number of Books   _____                  

Total Amount for Books   _______________

Colorado Residents add 2.9% sales tax   _______________

Shipping & Handling (see below)   _______________

Grand Total   _______________

 
 
Shipping & Handling
     Call +1 (719) 838-0100 for the Shipping & Handling charge.
Additional Payment Methods
     Credit Card: e-mail your order to orderdesk(at)e-mail.com and phone in your credit card information.
     Personal Check: Make checks payable to Justin Schlosberg.

Mail this form to:
Old Man Berkins
 attn: Justin Schlosberg
P.O. Box 4671
Breckenridge, CO 80424

 Phone: +1 (719) 838-0100
(9:00 AM to 11:45 PM Mountain Time)