Click here for a printable form

Print this form and mail with payment enclosed to:

Morgen Kuberek
6224 Solitaire Lane
Columbus, OH 43231

Orders must be accompanied by check or money order payable to the Central Ohio Sierra Club

Yes, I want to order:

 ___ Wilderness Wall Calendar(s) $11.00 ea. including tax

___ Engagement Calendar(s) @ $12.00 ea. including tax

___ I will pick up my order at the ___Oct. ___Nov. ___Dec. monthly program.

___ Please mail my order.

Alternatively, orders may be picked up in Worthington, pay at pickup.  Contact

Name (please print clearly)____________________________________________

Address _________________________________________________________

Enclosed is payment for ___ calendars $________

Shipping and Handling $________
Please add $3.00 for each additional calendar sent to a different address.