Lt. Col. William H. Lewis Order

Please print and mail to:
            Ann Oldham
            269 Oldham Place
            Pagosa Springs, CO 81147-9614

Price:                                                                                 Quantity            Total
Book:                          $14.95(each)                                   _______           ________
Tax(CO residents)          $  1.03(each)                                   _______           ________
S/H*:1 Book $5.00 add $1.00 per additional book.            _______           ________

TOTAL ENCLOSED                                                                                $________


Please print: Name:_____________________________________________________

Address:_____________________________________________________________

City:____________________________________State:______ZIP+4_____________

THANK YOU FOR YOUR ORDER