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The Anomalist Order Form for US and Canadian Customers

Your name:__________________________________

Address:____________________________________

___________________________________________

Phone number:_______________________________

Email:______________________________________

 Please check the box for the issues you want:

 The Anomalist 1-------------------------SOLD OUT
 The Anomalist 2..............................SOLD OUT
 [ ] The Anomalist 3............................$9.95
 [ ] The Anomalist 4............................$9.95
 [ ] The Anomalist 5............................$9.95
 [ ] The Anomalist 6............................$9.95
 [ ] The Anomalist: 7...........................$9.95
 [ ] The Anomalist: 8...........................$9.95
 [ ] The Anomalist: 9...........................$9.95
 [ ] The Anomalist 10 .......................$12.95

Add Postage...$2.50 for US Orders
 or $4.00 for Canadian Orders
 (No matter how many issues you order!)


 Subtotal: $________

Total Amount Enclosed: $___________

Send your check or money order in US dollars payable to Dennis Stacy and this order form to:

The Anomalist
 5150 Broadway #108
 San Antonio, TX 78209-5710