POLEBRIDGE PRESS

Polebridge Press Books, Tapes and Back Issues Order Form

Print, complete, and mail or fax this form to:
Polebridge Press
P.O. Box  7268
Santa Rosa, CA 95407
(707) 523-1323, toll free (877) 523-3545, fax (707) 523-1350
e-mail polebridge@westarinstitute.org

*Westar members receive a 20% discount on books and tapes from Polebridge Press. There is no discount on back issues of The Fourth R or the Forum.

**California residents add 8% sales tax.

Shipping within the United States:  $6.00 for first item, $.75 for each additional item.
Canadian shipping in U.S. dollars: $9.00 for first item; $2.00 for each additional item.
All other countries: actual shipping charges will be added to your credit card. Please indicate surface or air.
 

Ship to:

Name                                                          

Address                                                       

City                                    State                

Zip                       Country                              

E-mail                                                        

Day Phone                                                     
 

Billing:

All orders must be prepaid.

  Check or money order enclosed, payable to Polebridge Press
  (U.S. dollars drawn on a U.S. bank only)

Please bill my  Visa  MasterCard  Discover  AmEx

Name                                                          

Card Number                                                   

Security Code (Visa only)________________________
            (the last three digits in the signature block on the back of the card)

Exp. Date             Signature                              

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