Order Form

Use this form to order publications.  Please indicate how many copies you would like from the drop down menu. After completing this form, print it using your computer's print function, and mail the completed form with your payment, in US funds, via check or money order payable to Pitch-Black LLC, to:

Pitch-Black LLC
3232 S. 1st Street
Springfield, IL  62703
United States

Shake The Thunder Down $12.95  x copies = $
    Illinois buyers add 6.25% tax (.81) + $
        Total     $

Where would you like your order sent?

Name:
Mailing Address Line 1
Mailing Address Line 2
City, State, Zip code
Country
Telephone Number
Email Address

Please enter any special comments in the box below:
(e.g. Special shipping instructions, request email confirmation of order received, etc.)


Thank you for your order. Please print this page using your computer's printer function and mail it in with your payment in US Funds.

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Send mail to davidpitchford@daybreakpoetry.com with questions or comments about this web site.
Last modified: 10/05/07