ORDER FORM FOR CD-R & BOOK

THE AVERY-MORGAN BURIAL GROUND IN GROTON, CT
by Frederick E. Burdick

Name: _______________________________________

Street Address: _______________________________________

City, State & Zip Code: ________________________________________

Telephone: (______) ________________________________

E-Mail: _________________________________________

Please check item(s) ordered:

CD-R....................Quantity ____ @ $20 each = $ ______

Booklet.................Quantity ____ @ $20 each = $ ______

Set(1 of each)........Quantity ____ @ $35 each = $ ______

Total Enclosed...................................................$ ______

Send a Check or Money Order made payable to "Frederick E. Burdick" to:

Frederick E. Burdick, 595 Taugwonk Road, Stonington, CT 06378

Please remember: Proceeds in excess of production and shipping costs (US Mail) will be contributed to The Avery Memorial Association. If you have any questions, please phone Fred at 860-535-8454 or e-mail him at fburdick@comcast.net