Last name First Name ID #
Street address Address 2 City State/Province Zip/Postal code Home Phone Email address
Please provide the following ordering information:
Dept Course # Section CRN Instructor
Choose one of the following options: Pick Up (sign when picked up) Required Books Only Signature: Required and Optional Books Date: Choose one of the following options: New Books Used Books (if available) Used Books ONLY Fill out the following information: Pre-Pay_____ (only option) NO BOOKS WILL BE PULLED WITHOUT PAYMENT. Credit Card: Visa______ MasterCard_____ Discover____ Credit Card #__________________________________Expiration Date_________________ Cardholder Name______________________________ (NOTE: The books will be charged at the time of packing them-due to circumstances beyond the store's control, all books may not be available at that time and it is the responsibility of the student to obtain these books at a later time, when they become available.) Pick up August 1-20, 2008 Please return this form to the NGCSU Campus Connection, fax (706-864-1466) or mail to: NGCSU Campus Connection 82 B College Circle Dahlonega, GA 30597