Building Pennsylvania 
A Technological History of the Commonwealth
Please print this form, complete it, and send it along with a check made payable to:

Thomas P. Rich
1109 Wending Way
Lewisburg, PA
17837 

Your Name:


Address:


City:


State:


Zip Code:


Phone Number:


Email Address:


Enter Number of EBook CDs Requested: (enter SITE for site license)
No.________

Cost: (includes all charges)

On a per CD basis: $30.00

On a computer lab site license basis: $250.00 (for labs with up to 35 computers) 

Enter Total Amount:
$_____________

Today's Date: