Book Order Form

Time Outs for Grown-ups (paperback)    $10.00 each      Quantity_____           Total__________

Shipping is $5.00 for the first text and an additional $1.00 for each additional text

Total Amount enclosed___________

Shipping Information

Name:________________________________________________

Address:______________________________________________

City:_______________________ State________ Zip:__________

Email:________________________________________________

Phone (optional):________________________________________

Mail the completed form with a check or money order (no cash) to:

Sheila Buska
569 Nothomb St.
     El Cajon, CA 92019-2522

Your order will be confirmed by e-mail when received.