Mail Order Form
Dale Earnhardt: Rear View Mirror

Hardcover Book:  $28.95 US
Leather-bound Book:  $48.95 US

Print, complete and mail this page.

Illinois Residents: Add 7.25% sales tax.

Shipping & Handling
Continental US: Add $6.00 for first book and $1.00 for each additional book.
Outside Continental US: Add $7.00 for 1st book and $1.00 for each additional book.

Shipping Information (all fields required except Company/Institution)
First Name	_____________________
Last Name	_____________________
Company/Institution	_____________________
Address	_____________________
City	_____________________
State/Province	_____________________
Zip Code	_____________________
Country	_____________________
Phone	_____________________
Email	_____________________
Billing Information (leave blank unless not included or different from shipping info.)
First Name	_____________________
Last Name	_____________________
Company/Institution	_____________________
Address	_____________________
City	_____________________
State/Province	_____________________
Zip Code	_____________________
Country	_____________________
Phone	_____________________
Email	_____________________
Payment Information
Leather Bound Quantity:	Qty ____ x $48.95 US	=   ___________
Hardcover Quantity:	and/or Qty ____ x $28.95 US	=   ___________
--------------- Shipping (U.S.)	--------------- $6.00 for first book + $1 per additional book	- =   ___________
or (Non U.S.)	$7.00 + $1 peradditional book	=   ___________
Sub Total		___________
Tax (Illinois Residents)	Sub Total x .0725	=   ___________
Total		___________
Payment Type	_____________________
-	Am. Express, Discover, Mastercard, VISA, Check, Money Order
Credit Card No.	_____________________
Expiration Date	_____________________
Make checks payable to:      Sports Publishing Inc. Mail your order to:      The Earnhardt Connection      P.O. Box 53      Clarkston, MI 48347-053

Thank you for your order!

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