O R D E R F O R M

Mail this form to:
Generation Word
P.O. Box 399

Waukee, Iowa 50263

Ordered By:

Name:________________________________

Business: _____________________________

Address:______________________________

City, State, Zip:________________________

_____________________________________

Phone: _______________________________

Ship To: ( ____ “X” here if it is the same as above)

Name:________________________________

Business: _____________________________

Address:______________________________

City, State, Zip:________________________

_____________________________________

Quantity	Item #	Description	Price	Total
	1000	Book: “Hope For America’s Last Generation	$14.95

Shipping

TOTAL

Shipping in the United States :

1-2 books = $3.00 3-5 books = $6.00 6-10 books = $9.00

• Payment must be received before we ship. Please include check or money order.
• Any shipping damage must be reported to carrier within 10 days after delivery.
• Returns are accepted for 30 days after shipping.