Printable Order Form

To order by mail or fax, please fill out this form and return to:

Bayou Publishing, 2524 Nottingham, Houston, TX 77005-1412
      Fax: (713) 526-4342 
      Phone:(713) 526-4558
      E-mail: Reveal this e-mail address

For those with dial-up accounts or those who prefer unformatted printing.
Print out the page below.

For a fully formatted Order Form download one of the following files.
Order Form MS Word
Order Form PDF

BILL TO:

      Name:          ___________________________________

      Institution:   ___________________________________________
                                                                          
      Address 1: _______________________________________
 
      Address 2: _______________________________________
 
      City:     ________________________ 

      State:    _________ 
                                                                           
      Zip Code: _________

      Daytime Phone Number: (   ) ____________________ 
                                                                          
      E-mail Address:        _________________________


                                                                          
SHIP TO (if different):

      Name:          ___________________________________

      Institution:   ___________________________________________
                                                                          
      Address 1: _______________________________________
 
      Address 2: _______________________________________
 
      City:     ________________________ 

      State:    _________ 
                                                                           
      Zip Code: _________

      Daytime Phone Number: (   ) ____________________ 
                                                                          
      E-mail Address:        _________________________




     Please Send The Following: 

     Title:         _______________________ ______________________ ______________________

     ISBN or Cat. # _______________________ ______________________ ______________________

     Price:         _______________________ ______________________ ______________________

     Quantity:      _______________________ ______________________ ______________________
  
     Amount:        _______________________ ______________________ ______________________
                                                                             
     Subtotal:      _______________________
                                                                             
     Sales Tax:     _______________________   (Tx residents 8.25%)     

     Shipping & Handling __________________
 
     TOTAL:         _______________________
                                                                             
     *S+H charges: USPS Media Mail $3.45, USPS Priority Mail $4.95,
                   UPS Ground $7.25, FedEX Overnight $14.00

     
     Please send a Bayou Catalog: _____



     Method of Payment: Visa____ Mastercard____ American Express____ Discover____

     Card Number:       ____________________________________________

     Expiration Date:   Month______  Year______
	
     CVS code: _____________________________
     
     Cardholder: ___________________________________________________  
     (Please type name exactly as it appears on your card) 

     Full payment by check, money order, or credit card should accompany all orders 
     from individuals. Official institutional purchase orders accepted on a net 30, 
     FOB Houston basis. 

     Comments: