Subscription Form

United States	US $26.00
Canada	US $30.00
Elsewhere	US $37.00

For those who live outside the United States, payment should be made in U.S. Dollars:

Via a money order or check in U.S. dollars from a U.S. bank.

Via U.S. currency sent through the mail.

I am enclosing $_________ for my 2004 subscription to the Kielce-Radom SIG Journal. Please send my journals to:

Name __________________________________________________________________________

Address _______________________________________________________________________

City, State, Postal Code ______________________________________________________

Country _______________________________________________________________________

E-Mail Address ________________________________________________________________

Phone Number ______________________________________   Date: ___________________

I am paying by: __ Check (Number: _______)     __ Money Order      __ Cash

____ I also wish to participate as a Patron and am enclosing US$ ______________
     toward the fund.

Back issues may also be ordered --
Each annual volume (4 issues) is $26.00 in the US, or US$30 in Canada, $37 for other countries.
____ Volume 1 (1997)  (4 issues, 236 pages)
____ Volume 2 (1998)  (4 issues, 208 pages)
____ Volume 3 (1999)  (4 issues, 264 pages)
____ Volume 4 (2000)  (4 issues, 280 pages)
____ Volume 5 (2001)  (4 issues, 280 pages)
____ Volume 6 (2002)  (4 issues, 272 pages)
____ Volume 7 (2003)  (4 issues, 288 pages)
____ Special: All seven back volumes (28 issues, 1,828 pages):
              $175 in the US, or US$195 in Canada, $215 for other countries.

Mail your payment and this form to:

Kielce-Radom SIG
Gracie Station
P. O. Box 127
New York, NY 10028
U.S.A.

Subscription Form

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