Akirim Press Mail Order Form

Print this mail order form and send check or money order made payable to Akirim Press to:

Akirim Press
P.O. Box 291403
Columbia, SC 29229

Please fill out form in its entirety.  Thank you for your purchase.

                                                          
 Enter Quantity             Price

Secret                                                          ____            $13.95      

Colored Lily, Poppa Took My Innocence      ____           $15.95

Single Again
                                               _____          $15.95

Ghetto Eyes
                                               _____           $12.00

________________________________________________________________________     
                                        
                                                           Sub-Total:    ________
                                                   Shipping/Handling:
 $           
                                                   Enclosed Total:    ________
Shipping/ Handling is $3.95 for one book and only $1.99 for each additional book.  All books
will be autographed by the author.  Thank You.

PURCHASER'S INFORMATION(Please fill out in its entirety. Purchasers can type mailing information in fields
below.)
Name:
Mailing Address:
Telephone:
(not required)
Email:
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