Simply fill in, print form and send it to the address below.
    The Sierra Club
   Dave Sapak, 136 Circle Drive, West Pittston, PA 18643

Please fill out the information below:

First Name:
Last Name:
Address:
City:
State:
Zip: -
Phone:

Item

 Cost Quantity

Total
Engagement $13.00
Wilderness $12.00
Total
Shipping - $3 for 1st calendar   + .50 each additional calendar

Grand Total

Please make checks make it payable to the NE PA Sierra Club
PA Sales Tax - 6% already included in cost