Mail to:
Sandra K. Gorin,
205 Clements Avenue, 
Glasgow KY 42141-3409


Your Name _________________________________________________________

Address ___________________________________________________________

City ______________________________________________________________

State _________________________________ Zip Code __________________

Email Address _____________________________________________________

Phone # (__________) - ______________ - ___________________________


Items Ordered:

____________________________________________________ $ ____________

____________________________________________________ $ ____________

____________________________________________________ $ ____________

____________________________________________________ $ ____________

____________________________________________________ $ ____________

____________________________________________________ $ ____________

____________________________________________________ $ ____________

                                            Subtotal $ ____________
                          
                      6% KY Sales Tax if Applicable* $ ____________
                                
                                               Total $ ____________

*In-state libraries do not pay tax, please include tax number with order.