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Offline Order Form
US$17.00

System Requirements: Windows 95/98/2000, Internet Explorer Browser ver. 4.0 or better. This is a digital ebook. Hardbound book is not available.

Be sure to include your email address so we can send you the download instructions once your order has been processed. 

    Ordering Options:

    1. Complete, print, and fax the following form to us 24 hours at
    1-434-984-2528.

    2. Complete, print, and mail the following form to us at:

          Donegal Direct LLC
          1502 Loving Road
          Gordonsville, VA 22942

    3. If you prefer to pay by check or money order, simply make payable to Donegal Direct and mail the completed form to the above address.

First Name:

Last Name:

Company:

Address:

City:

State:

Zip Code:

Country:

Phone:

Fax:

Email:

Paying By:

Credit Card
Debit Card
Check (Make Payable to: Donegal Direct)
Money Order

Credit or Debit Cards:

Visa MasterCard

Card Number:

Expiration Date:

(mmyy)

Signature:

 ______________________