WEB ORDER FORM 
--------------
Royal Fireworks Publishing Co * Order Dept * First Avenue
PO Box 399 * Unionville * New York 10988-0399
(845) 726-4444 * FAX: (845) 726-3824 email: mail@rfwp.com

Bill To:
Name_______________________________________________________
School_____________________________________________________
Street Address_____________________________________________
City_________________________State__________Zip____________
Date_________________Purchase Order # _____________________
Visa/Mastercard # _________________________________________
Expiration Date____________________________________________
Authorized Signature_______________________________________

Only institutional purchase orders will be accepted. 
Individuals must include payment with order. Please be sure 
to include shipping with payment. Foreign orders should be 
prepaid in U.S. currency. Checks should be made payable to 
"Royal Fireworks Publishing Co" and sent to the above address.

Order #   Quantity   Title              Price each     Total
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
                                      Order Total $_________
                             Shipping & Insurance $_________ 

(orders up to $40.00, add $4.00; orders of more than $40.00 
add 10%. non-USA orders will be billed for shipping at cost 
for best available delivery method.

             Sales Tax 7.5% (N.Y. Residents only) $_________
                            Total Amount Enclosed $_________
Ship To:
Name________________________________________________________
School______________________________________________________
Street Address______________________________________________
City___________________________State__________Zip___________
Subjects/Position_____________________________Grade_________