To order the 85th Anniversary Issue of POETRY
Print and fax this form to:

(312) 255-3702
Or print and mail to:
POETRY
60 West Walton Street
Chicago, IL 60610
(312) 255-3703

NAME:

ADDRESS:



Please send me ____ copies of the 85th Anniversary Double Issue
@ $6 per copy $____
Add $2 postage & handling ($3 outside U.S.) $____


¤ Enclosed is my check in the amount of $____

¤ Please charge my ¤ VISA ¤ MASTERCARD #:
Expiration Date:

Signature:

Your telephone number: