WELLS BOOKS (A.B.A.C.) Secure Order Form Note: if you prefer, you can print this form and mail or fax it to us at: Wells Books (A.B.A.C.), 226 Main St, Box 1630 Liverpool NS Canada B0T 1S0 or Fax: 1-902-356-2091 Please ship me the following: Publication Cost Method of payment:: Check (Canada & US Funds only) Money Order (Canada, US & Intl.) Credit Card Credit Card Information:: Visa Mastercard Credit Card Number Expiry Date Card Security Code Name on Card Signature (for mail and fax orders) _________________________ Ship to: Name Mailing Address City Province/State Postal/Zip Code Country Phone Fax E-Mail Bill to: (If different from shipping address) Name Mailing Address City Province/State Postal/Zip Code Country Phone Fax E-Mail Postage choice and other instructions or comments: Click on "Send Order" to submit your order

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