CFA Order Form

Cogswell Family Association

crest1.GIF (12460 bytes) A non-profit corporation, organized in Mass., in 1989, dedicated to preserving the history of the Cogswell family

Print out this form, complete the appropriate fields (please print) and mail to address shown below.

Ship to: Name: ____________________________________________

Address: __________________________________________

City: ________________________________________

State or Province: _______________________

Zip Code: ________________

Payment by: Check Only Amount Enclosed: $_____________

Please make checks payable to: Cogswell Family Association, Inc.

5902 Golden Road

Sebring, FL 33875-6099

Payment Policy: Prepaid

Item No.	Description	Unit / Cost	Quantity	Total Amount
	"Descendants of John Cogswell"
	CFA Members	1st copy / $55.00
	Additional Copies	each / $50.00
	Non-Members	1st copy / $65.00
	Additional Copies	each / $65.00

	CFA New Member 1 year	New Member / $10.00
	CFA Membership 1 year	Individual / $20.00
		Family / $30.00
	* CFA Membership qualifies purchaser for members price above

SELECT	Handling, packaging, and:
	Priority U.S. Mail	each / $9.40
- OR -	4th Class Book Rate (US Only)	each / $4.55
	U.S.P.S. Insurance (optional)	each / $1.60
- OR -	Ship to Canada	each/$9.00
		Total Due:	--------------	$

Special Instructions: ________________________________________________________________________________________

____________________________________________________________________________________________________________

To inquire about your order: Phone: (863) 471-2735

Email:

(Updated June 8, 2010)

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