Order Form

To order, print out a copy of this form and mail it to the address provided below. Your order will be shipped 3rd Class Book Rate, Insured. To add photographs from Bloomfield Missouri: Highland in the Swamps, click here for Photo Form. Please allow three (3) weeks for delivery.

Title	Quantity	Price Ea.	Shipping	Subtotal
Bloomfield Mo.: Highland in the Swamps		$39.00	$6.00	$
Complete History of Butler County		$35.00	$4.00	$
History of Stoddard County		$25.00	$3.00	$
Stoddard County Marriage Records		$ 8.00	$3.00	$
Bloomfield Missouri photos only: Transfer Total# of Photos from the Form Below		$6.00	$2.00

Total Order:

Please print or type the following information:

Name:
Address:
City:	State:
Country:For orders outside the Continental U.S., email us your location so that we can determine shipping costs.	Zip:
Telephone:
E-mail:

Mail this form and your check or money order (payable to Robert H. Forister) in the amount of the "Total Order" above to:

Robert H. Forister
County Histories of Missouri
PO Box 25
Bloomfield, MO 63825

PHOTO FORM: Photographs (size: 4"x 6") from the book Bloomfield Missouri: Highland in the Swamps are available for $6.00 each. Shipping for up to 10 photographs is $2.

Caption	Page Number	Quantity
		#
		#
		#
		#
		#

Total No. of Photos Ordered: transfer this total into the form above

This site was created for County Histories of Missouri by Silver Moon Designs.