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LEGACY QUARTERLY SUBSCRIPTION FORM

Name ____________________________________________________________________________
Address _________________________________________________________________________
City _____________________________ State/Prov ________________________
ZIP _____________________ Country _________________________
Telephone ____________________________
Email ____________________________________________
One year -- $24.95 (Canadian subscribers add $6 per year. Overseas subscribers add $20 per year)
Two years -- $48.00
Total amount in U.S. funds $ __________________

Card # ____________________________________________
Expiration _____________ 3-digit security code_____________
Signature ____________________________________________

Send To: Legacy Quarterly Magazine, P.O. Box 129, Rushville, OH 43150-0129