Special Interests Publishing

Mail Order Form

Book Title Quantity Amount Total      
Get Back On Your Feet! What Every Injured or Ill Person Needs to Know   $24.95  
Shipping See Chart Below    
Sales Tax - Texas Residents Only 8.25%    

Shipping Charges
UPS Ground, Federal Express Ground & Priority Mail

First Book $4.00
Each Additional Book Add $2.50

I have enclosed my check or money order payable to Special Interests. Please send my book(s) to:
City, State, Zip:
Email address:
Phone Number:

Email confirmation of your order will be transmitted to the address provided.

Please send this completed order form along with your payment to:

Special Interests Publishing
4646 Hwy 6 #123
Sugar Land, TX  77478