Border Witness Order Form

Please send___________copies of Border Witness: Youth Confront NAFTA. Suggested donation for the book is $30.00 plus $3.50 shipping and handling per copy.

TOTAL ENCLOSED: _________________________________________

Enclose a check made out to the New York State Labor-Religion Coalition or complete the information below for credit card orders. Thank you for your donation.

Circle card type:

Master Card

Visa

Discover

American Express

Card number:________________________________________________

Expiration date: ______________

Signature: ___________________________________________________

Name (Please print.)_________________________________________

Organization________________________________________________

Street address______________________________________________

City_________________________________ State________ Zip_____

Phone (day)________________________(evening)________________

Fax ______________________________________________________

Email_____________________________________________________

Mail this form along with payment to
Border Witness Order
NYS Labor-Religion Coalition
800 Troy-Schenectady Road
Latham, NY 12110-2456