Book Order Form

Print this order page and mail in the completed form with your check.

Item	Cost Per Book (Including Postage)	Quantity Desired	Total
Book: "Dear Doctor Humor"	$12.00	________	________
Name:
Address:
City:
State:
Zip:
Phone Number:
Personalize a Copy to (Name):
Mail check payable to: National Association for the Humor Impaired 3356 Bayside Court, Suite 201 La Crosse, WI 54601