ORDER FORM for United States - The Family History Shop

To:- Beryl Pitcher
         318E 1655 SO
         Orem, UT 84058
         U.S.A.

Please send me the following microfiche/discs/books:-

Qty.	Ref.	Title	Price
		Postage*   US$
		Total   US$

*Postage: please add US$ 1.00 on any fiche order; prices for postage of books on application.

Delivery may take up to 28 days.

    Name:                                                                                   Phone/e-mail:                                                                              

Address:                                                                               

                                                                                             

       ZIP:                                           

I enclose a check/postal order for US$                                            

( Checks made out to Worldwide Family History Services )

Signature                                             Date