Print this form, check the box next to the magazine you would like to receive and indicate how many copies you would like (5 copies maximum) and mail along with payment.

Magazines are $5.00 per copy.

Send completed form and a check for the total to:

Malcolm Media, P.O. Box 626, Clovis, CA 93613.

Magazines will be sent upon receipt of check.

American Vineyard       Issue Date ______Vol._____ No. of copies.___($5.00 ea., max. 5 copies)    Cost_______

California Dairy            Issue Date ______Vol._____ No. of copies.___($5.00 ea., max. 5 copies)    Cost_______

Pacific Nut Producer    Issue Date ______Vol._____ No. of copies.___($5.00 ea., max. 5 copies)    Cost_______

Vegetables West            Issue Date ______Vol._____ No. of copies.___($5.00 ea., max. 5 copies)    Cost_______

Total                                           Total

No. of copies._______                   Cost_______

P.O. Box 626 • Clovis, CA 93613-0626 • 559-298-6020 • fax 559-323-6016