Please print out a copy of this page, complete and send this form along with a check payable to "Treasurer, NHRHTA, Inc." to:
Bill Nickerson
9 South George Washington Road
Enfield, CT 06082
Having trouble printing this page? Try clicking anywhere on this form with your left mouse button first before printing to make this the active frame.
| Quantity | Total Price | ||
| NHRHTA 2007 Calendar @ $9.95 | |||
| 6% Connecticut Sales Tax ($0.60 per Calendar): | |||
| 5% Massachusetts Sales Tax ($0.50 per Calendar): | |||
| Shipping (per calendar -- contact Bill Nickerson if ordering more than 3): | ______ calendars X $2.05 each | ||
| Amount Enclosed: | |||
Note: Unlike prior years, this year we will not be shipping the calendars via bulk mail in order to ensure timely delivery. If you are ordering more than 3 calendars, please contact Bill Nickerson.
Please make your check payable to "Treasurer, NHRHTA, Inc." Connecticut and Massachusetts residents must include sales tax. Mail your check and this completed order form to:
Bill Nickerson
9 South George Washington Road
Enfield, CT 06082
Please print the following information:
Name (Last, First):_____________________________________________________
Address:________________________________________________________________
City:____________________________ State:__________ Zip:_________________
Telephone:_____________________ Membership #:__________
_____ Please check if you are an NHRHTA member and this is a new address.