Mail Order Form

A Portrait of Deltaville 25th Anniversary Edition, 2001

Please fill out the order form below and mail to:

DCA Book
Box 211
Deltaville, VA 23043

Ship to:

Name:__________________________________________________

Address:________________________________________________

City: ________________________ State ________ Zip _________

Telephone: __________________

A Portrait of Deltaville	Quantity	Sub Total
$20.00 per book
5% sales tax for VA addresses = $1.00 per book
Shipping $4.00
Total

The book is also available at Nauti Nell's, Latitudes, Pat's Gallery, Hurd's and other community locations for $21.00 ($20.00+$1.00 tax).