Powell's Bookstores Online Order Form

We are currently in the process of developing an online order system for your convenience. Please note that at this time this order form is NOT secure. We ask that you phone or fax your credit card number in for the best security. We also are happy to take personal checks and money orders for your order. However, we will not process your order without payment.
Please give us an order reference number, such as today's date and your last name, so that we can easily reference your order when you submit payment.
We require a street address for shipping. We also require that you inform us whether we are shipping to a residence or a business address (UPS does not consider home businesses business addresses so neither can we.) Our current shipping charges are $5.50 for the first book and $1.00 for each additional book for continental US shipments, if you pay by credit card the correct amount will automatically be charged to your card. (For international orders we will quote shipping prices via email upon receipt of your order.)
We will send you an email confirmation upon receipt of your order and payment and again when your order ships. Please contact us with any questions at orders@powellschicago.com. Thank you for your order.

Your name:
Your email address:
Order Reference:
	* choose a reference, such as the date and your last name

Billing Address		Shipping Street Address
Address:		Street Address:
City:		City:
State:		State:
zip code:		zip code:

	Ship to billing address (a street address is required for shipping)
Ship type:	Business Address Residential Address
Book(s) Ordered:	Please include our book number (letter plus five number code such as S12345, included in book description,) book title and our list price For example, "S1235 My Book $25.00"
Payment Info:
Additional Instructions:	Please include any additional instructions here
Coupon Code	or	T-shirt Special	What's this?