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Name: _________________________________________

Address: ________________________________________

City: ______________________, State:_____ Zip:_______

Phone:____-________

 PRINT AND MAIL THIS FORM TO: 

Stephens College
Campus Box 2034
Columbia, MO   65215
Year   Cost    Quantity

1980   $2    x   _____
1981   $2    x   _____
1982   $2    x   _____
1983   $2    x   _____
1984   $2    x   _____
1985   $2    x   _____
1986   $2    x   _____
1987   $2    x   _____
1988   $2    x   _____
1989   $2    x   _____
1990   $2    x   _____
1991   $2    x   _____

 Year    Cost    Quantity

1992   $2    x   _____
1993   $2    x   _____
1994   $2    x   _____
1995   $2    x   _____
1996   $2    x   _____
1997   $2    x   _____
1998   $2    x   _____
1999   $2    x   _____
2000   $2    x   _____
2001   $2    x   _____
2002   $2    x   _____
2003   $2    x   _____

  = $______
Make Checks Payable to STEPHENS COLLEGE $2 Shipping for first book ($0.50 extra for additional) = $______

TOTAL:

$______