To order, please complete this form and send to:

Dr. James M. Brophy III, Editor
931 Glen Flora
Waukegan, IL 60085
Tel: (847) 662-0299
Fax: (847) 662-0685

E-mail: PFADWJMB@aol.com

Please pay in advance (international Money Order or Credit Card)
in the amount of US$25.00 plus $5 postage per softcover book, or
in the amount of US$35.00 plus $5 postage per hardcover book,

For international orders add $6 for postage per single copy,
U.S. currency only. Please allow 4 - 6 weeks for delivery
Please do not send cash nor personal check.

Quantity of Order: ____________________________

Amount of Order : US$ ________________________

Orderer: ________________________________________________________
...................DR. Mr. Mrs. Miss. Ms.

SHIP TO:________________________________________________________

Mailing Address__________________________________________________

Mailing Address__________________________________________________

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Country_____________________________

Your Daytime Phone Number:________________________________________

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Payment Amount Enclosed
International Money Order: USD $ __________________