Minnesota customers must add 6.5% sales tax Please provide the following contact/user information. (Note: The following information is required): Item State Quantity Handbook(s) With binder(s). Georgia Iowa Minnesota Missouri North Carolina Ohio Handbook(s) WITHOUT binder(s). Georgia Iowa Minnesota Missouri North Carolina Ohio Binder(s) only. Georgia Iowa Minnesota Missouri North Carolina Ohio eBook Subscription. Georgia Minnesota Missouri North Carolina Ohio

Billing Information Company: Contact Person: Address: Address2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip/Postal Code: Phone Number: Fax Number: Email Address: Shipping Information (if different from billing) Company: Contact Person: Address: Address2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip/Postal Code: Phone Number: Fax Number: Email Address:   Tax Exempt: Yes    No   Yes  No      Please bill me for this order, plus postage and handling charges. Yes  No      I am prepaying. Mariposa Publishing will pay postage and handling charges.             Yes  No  Payment by check: Print this form, enclose a prepayment check for $________ and mail it to Mariposa Publishing. (MN customers please add 6.5% sales tax unless exempt).             Yes  No  Payment by credit card: Credit Card: Choose Card... Visa Mastercard American Express Discover Card Number: Expiration Date: Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 2007 2008 2009 2010 2011 2012 2013 Cardholder Name: Comments: