To order via this FORM PAGE, simply fill in the information below, print the page, and then mail it along with payment by cheque (made out to Excelsior Publishing), to:
EXILE/Excelsior Publishing, 134 Eastbourne Ave, Toronto ON, M5P 2G6, Canada
(Allow 2-4 weeks for delivery from the time we receive your request).
First Name:
Last Name:
Institution Name:
Library Name:
Address:
Add. line 2:
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Country:
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List the ISSUE(S) you want to buy:
(Please enter Issue #, quantity, and total cost; eg. "Issue 24.3 x 3copies = $36.00CDN" - Use the pull-down menu below for Issue/Price reference)
TOTAL $: plus $4.00 S&H per issue = $: CDN$ US$
Date of your request (Day/Month of 2005):
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