MCLHR PUBLICATION ORDERING FORM 

To purchase items from the publication list, please complete this form 
and mail it along with prepayment to the address shown below.

NAME:                _______________________________

STREET ADDRESS:      _______________________________

CITY, STATE, ZIPCODE:_______________________________

EMAIL:  _______________________

DESCRIPTION OF ITEMS: PRICE (PLUS S/H):

________________________________________________________________________

SUBTOTAL:                   $_______

+ Shipping and Handling:    $_______
if subtotal is:
$0 - $10.00 add $2.00 s/h
$11 - $30.00 add $4.00 s/h
$31.00 – $60.00 add &6.00 s/h
$61 – up add $8.00 s/h

+ 5.5% TAX (WI only) 	    $_______

TOTAL ENCLOSED:             $_______

Mail to:
Monroe County Local History Room
200 West Main St.
Sparta, WI 54656