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Mail Order Form - page under work
Please print a copy of this form, fill it out, and submit it with your payment to:
Powers Museum
P.O. Box 593
Carthage, MO 64836
(Make checks & money orders payable to: Powers Museum)
| Name | ________________________________________________ |
| Shipping Address | ________________________________________________ |
| City, State, Zip | ________________________________________________ |
| E-mail Address | ________________________________________________ |
| Telephone (optional) | ________________________________________________ |
| Quantity | |
| "Bird's Eye Print of Carthage, Missouri 1891" - $15.00 | __________ |
| Pictorial Story of the Oregon-California Trail - $8.00 | __________ |
| Arcadia's Carthage Missoui (picture book) - $24.99 | __________ |
| Jasper County in the Civil War - $25.00 | __________ |
| Tile - Carthage (Size Small) | __________ |
| Tile - Carthage (Size Large) | __________ |
| X Card - Carthage | __________ |
| X Card - Carthage | __________ |
| Small Magnet - Carthage | __________ |
| Large Magnet - Carthage | __________ |
| Route 66 Children's Book | __________ |
| Tile - Hollywood Cafe | __________ |
| X Card | __________ |
| X Card | __________ |
| Small Magnet | __________ |
| Large Magnet | __________ |
| Museum T-Shirt | __________ |
| Tile - Westside of Courthouse Square | __________ |
| X Card | __________ |
| X Card | __________ |
| Small Magnet | __________ |
| Large Magnet | __________ |
| Jefferson Highway T-Shirt ________ Size _______Style (#1 or #2) | __________ |
| If gift, please give info for card or other instructions:_____________________________________ | ______________ |
| NEW 2012 Rt 66 Calendar $12.00 | __________________ |
|
SUBTOTAL (Shipping included in listed price) |
$______________ |
|
Tax (MO residents please add 7.388% on each item, not shipping cost) 2012 Calendar or Bird's-eye print: .74 cents each tax Oregon Trail booklet: .37 cents each tax Carthage picture book: 1.48 cents each tax Jasper County Civil War book: 1.48 cents each tax PM T-Shirt: JH T-Shirt: Tile - Small: Tile - Large Card: Magnet: Rt 66 Childrens Book: |
$______________ |
| TOTAL AMOUNT OF ORDER | $______________ |
|
(Include check or money order with this form) THANK YOU FOR YOUR PURCHASE! |
Copyright © Powers Museum
1617 West Oak • P.O. Box 593 • Carthage, MO 64836
e-mail: infonow@powersmuseum.com | phone: 417-237-0456
All Web site design, content and solutions are property of Powers Museum
