Name _________________________________________ 

Organization ____________________________________

Address _______________________________________ 

City/State/Zip  ___________________________________

Telephone___________________________

Publication Name(s)  

________________ Quantity ___ Cost_____ Total $_____

________________ Quantity ___ Cost_____ Total $_____

________________ Quantity ___ Cost_____ Total $_____

________________ Quantity ___ Cost_____ Total $_____

                                               Shipping & Handling       $   5.00
                                                                               

                                            Grand Total Enclosed     $_____


PAYMENT MUST ACCOMPANY ORDER

Please mail this order form and payment to:
United Way’s 211
137 River Drive
Wausau, WI 54403

Allow 2 weeks for delivery