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Media Consortium Book Order Form
To order your book(s) by mail, please print this form, fill it out and mail with a check or credit card information to:
The Media Consortium
Suite 102-231
2200
Wilson Blvd.
Arlington, VA 22201
Mailing information:
Your Name: __________________________________________
Address1: ___________________________________________
Address2: ___________________________________________
City, State Zip: _______________________________________
Choose your book(s):
[ ] Neck Deep (paperback), $22.95
[ ] Neck Deep (hardback), $29.95
[ ] Secrecy & Privilege (paperback), $22.95
[ ] Neck Deep + Secrecy & Privilege (paperbacks), $34.50
[ ] Lost History (paperback), $19.95
Please add $4 for postage.
Please make your check payable to The Media Consortium
If you'd like to charge this order to your credit card, please fill in your card information:
Visa/MasterCard#: _____________________________________
Exp. Date: _______________________
Signature: _______________________
Email us with any questions at: neckdeepbook@aol.com.