NCHS Publication Order Form


Name:  _________________________________________________________________

Address:  _______________________________________________________________

City:  _____________________________  State:  ______  Zip:  ___________


ITEM

QTY

PRICE EACH

TOTAL
       
       
       
       
       
       

TOTAL PRICE :
ADD 5% VIRGINIA SALES TAX :
ADD SHIPPING & HANDLING ($1.50 FOR FIRST ITEM, $.50 FOR EACH ADDITIONAL ITEM) :
GRAND TOTAL (PLEASE MAKE CHECKS PAYABLE TO: NCHS OF CHESAPEAKE) :

Mail order to:
Norfolk County Historical Society
298 Cedar Road
Chesapeake, VA  23322
 

Chesapeake Public Library System, 298 Cedar Road, Chesapeake, VA 23322-5598