New Jersey Boaters Guide Order Form

Please ship me:

 Qty ______ @ $24.95 each = $ ___________ Book total

 Add ______ NJ Sales tax: 7% (If shipping to an address in NJ) ($1.75 per book)

 Add ______ Shipping: $4.95 per book

 Total: $_________________

* Make all checks payable to: The New Jersey Media Group (All orders paid by personal check will be held until check clears)

* No personal information collected will be shared or sold in any way.

Billing Address:

First Name: _______________________ Last Name: _____________________________ 

Address: _________________________________________________________________

City: _____________________________ State: ___________ Zip: _________________

Phone number: _____________________ Alt. Phone: ____________________________

Email Address: ____________________________________________________________

Ship to Address: (if different from above)

Name: ___________________________________________________________________

Address: _________________________________________________________________

City: _____________________________ State: ___________ Zip: _________________

Credit Card Info:

_____ Visa      _____ MasterCard       _____ Discover     _____ Amex       (check one)

Card number: _____________________________________________________________

Exp. ___________ Security Code: _____________ (on back of card)

Name on card: ____________________________________________________________

Any additional notes: ______________________________________________________

Mail order form and payment to: The New Jersey Media Group, P.O. Box 34, Clayton, NJ 08312