If you wish to order back issues of Spirituality & Health magazine, please fill in the form below and then either print off and send with your check, or click the submit button to e-mail with invoice details.

First Name or initials	_____________________________________
Surname	_____________________________________
Delivery address	_____________________________________ _____________________________________
ZIP Code	_____________________________________
Telephone	_____________________________________
Your e-mail address	_____________________________________

Back Issues order

Indicate Month and Year:

1. ___________________________ x ______ copies
2. ___________________________ x ______ copies
3. ___________________________ x ______ copies

Total Cost ($10/copy) $__________________________

Payment Options:

Option 1: Credit Card
Card Type: Visa ___ MC ___ Discovery ___
Number _____________________________________
Name on Card _______________________________ Exp Date ___________________________________

Option 2: Check enclosed $ _____________________________________

Print this form and mail with check or credit card information to:
Spirituality & Health
75 Glen Road (Suite 200)
Sandy Hook, CT 06482

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