Organizational Subscription REQUEST FORM

Please print this page and send a completed copy to:
Community Works Journal
c/o Vermont Community Works, Inc.
PO Box 2251 South Burlington, VT 05407

Organizational subscribers will receive an invoice with each issue (4 per year).

Annual Cost: Annual total for budgeting purposes should be calculated based on 4 issues.

Calculate your cost as follows:
20-50 copies are $2.50 per copy + $12 s/h per issue
• 50+ copies are $2.50 per copy, s/h is included
example: 32 copies X $2.50 per X 4 issues per yr. = $320 + $48 s/h = $368 per year

Please call us at 802-655-5918 if you have questions or need assistance.

NAME OF ORGANIZATION: _________________________________________ DATE: _______
CONTACT PERSON: _________________________________

TITLE: ____________________________________________

DELIVERY ADDRESS: ________________________________________________

__________________________________________________________________

__________________________________________________________________

BILLING ADDRESS: __________________________________________________

__________________________________________________________________

__________________________________________________________________
TEL: ___________________________ FAX: ________________________

EMAIL: _________________________________________

ORDER INFO & COST CALCULATION:

# of copies: ____ X per copy cost: ____ X 4 issues per yr = $______ + $_____ (s/h)

TOTAL ANNUAL COST = $ ______ (based on above calculation)


AUTHORIZING SIGNATURE: ________________________________