Please see our 100% money-back guarantee at the bottom of the form.

Please fax (703.644.5492) or mail this form to: Poetic Expressions Publishing, PO Box 2367, Springfield, VA 22152. PLEASE PRINT

Name: ________________________________________________________________

Mailing Address: ________________________________________________________
            
City: ____________________________ State: ____________ Zip: _______________

Email: _________________________________________________________________

Daytime Phone Number: (______)___________________________________________

Number of books @$18.95 each ________________     total $___________________

Virginia addresses include 5% sales tax ($.95 for one book)  tax $ _______________

ADD Shipping via U.S. mail: for delivery in 7-10 days: $3.50

or to receive your book in 2-3 days Priority: $6.75          shipping $ ____________

Amount enclosed: (book+Virginia tax+shipping) $_____________or bill my credit card:

Name as appears on credit card: ___________________________________________

Credit card # _____________- ______________- ________________ - ___________

Expiration date: ____________________  CCV: ________________

Billing address of card: ____________________________________________________

________________________________________________ ZIP ___________________

Number of books requested: _______________

Authorizing signature: _______________________________________ date_________

What name would you like the book inscribed to: ____________________________________________________________________  

A signed copy or inscription by the author is offered at no additional charge for orders through this website or http://www.poeticexpressionspublishing.com

Our 100% money-back guarantee: If you are not completely satisfied with your book, please contact us at returns@poeticexpressionspublishing.com, you will need the code from your shipping label at that time.

We will issue a pre-addressed return label and return form. Simply return WITH YOUR SHIPPING LABEL the unmarked book within 30 days for a full refund (if ordered here or  www.poeticexpressionspublishing.com) or return it to the place you bought it to receive a refund.

If your book arrives damaged, simply return it, and we will replace your book at no charge.

To check on order status, please call 703.644.5492.