ORDER FORM, The Revival
Special Offer! Kansas libraries save 20%

Mail payment, via check or money order, to:
Dancing Goat Press
3013 SW Quail Creek Dr.
Topeka, KS 66614

Questions? (785) 273-3089 or contact us via email
Please make checks payable to "Dancing Goat Press"

Ordered by ________________________
Library name ___________________________
Address _______________________
City _______________ State ______ Zip _______
e-mail ____________________

Number of copies ordered ____________

Special to KS libraries @$10.36/ea ____________

KS sales tax* (@ $.75/ea.), if applicable ________
*If you are ordering in Kansas with a tax-exemption, please include your tax acct. # _________________

Shipping (@ $2.00/ea.*), if mailed ________
*NOTE: We mail Media Mail rate.

Total enclosed (check, money order or P.O.) _________
(Please make checks payable to "Dancing Goat Press")