| Please PRINT this page, fill out and use one of our 3 convenient ways to order: ---------------------------------------------------------------------------------------- MAIL TO: Fort Campbell Historical Foundation PO Box 2133 Fort Campbell, KY 42223 FAX: (931) 431-2620 PHONE: (Credit Card Orders Only) 9:00 AM to 4:30 PM CST (931) 431-2617 ---------------------------------------------------------------------------------------- Lithograph Order Form NAME: __________________________________________________ ADDRESS: _______________________________________________ CITY/STATE/ZIP: _________________________________________ HOME PHONE: ___________________________________________ BUSINESS PHONE: _______________________________________ FAX: ____________________________________________________ E-MAIL: _________________________________________________ ___________Service Member__________Veteran___________Civilian Division: ____________________Regiment:______________________ Battalion: ___________________Company: ______________________ Era Served: _________________Dates: _________________________ Lithograph: To purchase a specific print number, please call (270)439-9466/9465/9463 to check availability. 101st Museum Edition Sold Out Sold Out 101st Signature Edition ___ $95 $_______ 101st Regular Edition ___ $75 $_______ 160th Museum Edition: Sold Out Sold Out 160th Regular Edition: ___ $75.00 $_______ Euphrates Museum Edition ___ $150 $_______ Euphrates Signature Edition ___ $50 $_______ Euphrates “G-Day” Edition ___ $10 $_______ shipping and handling fee of $15.00 $_$15.00_ TOTAL $_______ PAYMENT METHOD (check one): Please do not send cash. Please make checks payable to the Fort Campbell Historical Foundation. ___ Check/Money Order Enclosed Quarterly _____Semi-Annually _____Annually __Visa __ MasterCard __Discover __American Express Credit Card Account # |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| Expiration Date: MO. |__|__| YR. |__|__| Signature: _________________________________________ |