Paddling Trails Map/Medallion - Order Form

Ms./Mrs./Mr.______________________________________________
Address__________________________________________
City ______________________________________ State _______ Zip _______
Daytime Phone ________________________________________
Email Address _________________________________________
Member? Yes ______ No ______
How did you hear about us? ____________________________________

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Quantity

Price

Total

Paddling Trails Map

_______

$5.00

$_______

Paddling Medallion

_______

$5.00

$_______

Paddling Trails Map and Medallion

_______

$9.00

$_______

Less 10% Members Only Discount

$_______

Subtotal

$_______

DE, MD, PA, VA, WV Residents Add 6% Sales Tax

$_______

Total Amount Due

$_______

Payment Type (Circle One)

Check/Money Order

Visa

Mastercard

Credit Card Number ________________________________
Exp. Date _______ (mm/yy)
CVV or CSV Number* __________
Signature ____________________________________________

(*CVV or CSV - VISA and MasterCard require the three-digit Card Verification Value (sometimes call Card Security Value) in addition to the card number. This number is typically found written on the right side of the signature line on the back of the card.)

Make checks and money orders payable to Friends of Blackwater

Mail order to Friends of Blackwater, Inc.
P.O. Box 1231, Cambridge, Maryland 21613

Or fax completed order form to 410-221-7738

Or call 410-901-6125 and leave a message to place an order. All calls will be returned.

For additional information, contact Wolf Hehn at Whehn@aol.com
Thank you for your order!