PLEASE PRINT
Name:___________________________________________________________
Title:____________________________________________________________
Agency Name:____________________________________________________
Shipping Address:________________________________________________
City:________________________ State:______ Zip Code:________________
Daytime Phone: (_______)__________________________________________
METHOD OF PAYMENT:
___ Check or money order enclosed (payable to California Rural Legal Assistance, Inc.)| Item Name & Size | How Many |
Price Each |
Total Price |
| Subtotal | |||
|
Sales Tax
(Orders shipped in California must add 7.75% tax or attach tax-exempt certificate) |
|||
| ORDER TOTAL | |||
Send this form with your payment to California Rural Legal Assistance, Inc., P.O. Box 35, Coachella, California 92236. Credit card orders may be placed by phone at (760) 398-7261 or by fax to (760) 398-1050. All prices include shipping and handling. ORDERS MUST BE PREPAID.