DUP Order Form

Daughters of Utah Pioneers
Order Form

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Mailing address:
506 W 400 S, Tooele, UT 84074

email:
groberts10@hotmail.com

Date:

Full Name:

PO Box:

Street Address:

City:

State:

Zipcode +:

Phone #:

E-mail:

Item#

Title/Description

#Pages or Size

Price ea.

Amount

Subtotal

Shipping & Handling (see below)

First Class (optional - $5.00)

Total

Shipping & Handling

$1.00--5.00
$ 2.00

$ 5.01--$15.00
$ 4.45

$15.01--$25.00
$ 5.45

$25.01--$50.00
$ 7.45

$50.01--$75.00
$ 9.45

$75.01--$100.00
$11.45

Foreign mail add $3.00 to above

email or
call us

If you have any questions or the number of pages for a history is not listed, please email to above email address or call 435-882-6801. Please leave phone# with message for Gwen if no answer.

Please fill out form, Print, then send with money to above address.
Make check or money order payable to:
DUP -Tooele

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Check

Money Order

	Daughters of Utah Pioneers Order Form
Click Logo to return to Home	Mailing address: 506 W 400 S, Tooele, UT 84074	email: groberts10@hotmail.com

		Date:
Full Name:	PO Box:
Street Address:	City:
State:	Zipcode +:
Phone #:	E-mail:

Item#	Title/Description	#Pages or Size	Price ea.	Amount






Subtotal
Shipping & Handling (see below)
First Class (optional - $5.00)
Total

Shipping & Handling
$1.00--5.00	$ 2.00
$ 5.01--$15.00	$ 4.45
$15.01--$25.00	$ 5.45
$25.01--$50.00	$ 7.45
$50.01--$75.00	$ 9.45
$75.01--$100.00	$11.45
Foreign mail add $3.00 to above	email or call us