The Animating
Apothecary Order Form
PO Box 1325, Battle
Creek, Michigan USA 49016
You can copy and mail, or drop
an email request for your order. We do coordinate invoices.
Phone
mail: 269-963-4945 or email at: jimmiddleton@juno.com
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Billing Address |
Shipping Address (if different) |
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Name: |
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Address: |
Address: |
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City: State/Prov: |
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Your email: |
Somone else's email: |
Things You Can't Live Without!
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Item |
Cost Each |
Quantity |
Total |
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Uncle Stan's Profusely Illustrated World of Pharmacy Calendar 2008 (WooHoo!) |
$8.50 |
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$8.50 |
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$8.50 |
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$1 |
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$1 |
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$1 |
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$20 |
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VIDEO: Pharmacy in Film (1917-1940) |
$20 |
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$15 |
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POSTCARD SET: 30 different cards! Almost sold out! Finally! |
$5 |
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$15 |
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$15 |
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CERTIFICATE: Martyr to the Mortar [Name: ] |
$3 |
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Coming soon--AUDIO CDs from the Animating Apothecary Public Domain Audio Collection (the joys of wax and shellac!) |
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Shipping: up to $10, add $2.50; up to $20, add $4, over $20, add $5 |
no tax! |
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Thank you for your order...You are a great human being... |
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Shipping |
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..a tribute to carbon based life forms everywhere... |
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Total |
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Now to pay up: (no American Express at this time...snif!)
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Check or M.O. |
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Visa |
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M/C |
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Discover |
MAKE CHECKS OR MONEY ORDERS OUT TO "THE ANIMATING APOTHECARY"
Credit Card Number:
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Expiration date: MM--YY
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Signature: ______________________________________________________________