TUOLUMNE CITY MEMORIAL MUSEUM, INC.

Post Office Box 1174, Tuolumne, CA 95379 - Phone (209) 928-3516

www.TuolumneMuseum.org/tccrs.htm

TCCRS Internet Order Form

Name___________________________________________________

Address_________________________________________________

City_____________________State_________ZIP________________

Phone ( ____ )__________________________ Date_____________

E-mail Address: ________________________________________

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Qty. Description Unit Price Amount

_____ Tuolumne Community $30.00 ea $ _________

Cultural Resources Survey

CA Residents Add Sales Tax (.0725 %) $ 2.18 ea $_________

USPS Shipping & Handling (USA only) $ 5.00 ea $_________

(Note: Book Rate Shipping Time Approximately 14 Days)

Thank You Total $_________

PRINT THIS FORM AND MAIL WITH YOUR CHECK

(NO CASH, CREDIT CARDS or COD's) TO:

Tuolumne City Memorial Museum, Inc.

Attn: Order Desk

Post Office Box 1174

Tuolumne, CA 95379