Speaker Request Form for Security Breach: The Murder of Tod McQuaid

Ship any information (to group's contact) using United States Postal Service and/or E-mail delivery:

Name
Organization
Street Address Continued
City
State/Province Zip/Postal Code
Country
Phone # E-mail

Brief reason that request for speaking engagement initiated by group:

Group's Choice Date and Time for speaking engagement (2nd Date and Time as Alternate):

Book Order Form for Security Breach: The Murder of Tod McQuaid:

Buyer information for Author book shipment & contact information (not available outside Author's own use):

Name
Major
Street Address Continued
City
State/Province Zip/Postal Code
Country
E-mail

Suggested/desired inscription provided to Author for consideration:

Please tell Jan and Rog briefly how you learned about this book or web site:

Any over payment donated to Parents Of Murdered Children (www.pomc.org).

1) Fill in this form. (Multiple buyers use Multiple-Books sheet that lists each buyer and his/her inscription preference.)

2) Print copy using your internet browser print function (print twice if you want record of printed copy).

3) Mail one copy (completed form) to Jan McQuaid PO Box 101112 Pittsburgh PA 15237 with Full Price of $15.00usd for each book; delivery only within the USA. Send in United States Postal Service using Check or Money Order for payment.

 

                      Copyright © 1999 [Janet Bailey McQuaid]. All rights reserved.    Revised: 12/04/06 

Thank you for printing your Speaker Request for Security Breach: The Murder Of Tod McQuaid.

 
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