Mail Order Form

$25 each book, plus shipping.
Shipping: For 1 book, $5.00 total. For 2 to 5 books: $10.00 total.

Please print this page and mail to:
Stacyville History Book, P.O. Box 184, Stacyville, IA

PLEASE PRINT CLEARLY. Phone number is required for questions on your order.

Name
Mailing address
City
State
Zipcode
Phone number
Book Quantity
+ Shipping	$5 for 1 book. $10 for 2 to 5 books.
Total Enclosed*	$

*Make checks payable to Stacyville Community Club.

Thank you for your order. Please allow 3 weeks for shipment. For questions, call 641-727-2428.