ORDER FORM FOR BOOK

THE AVERY-MORGAN BURIAL GROUND IN GROTON, CT
by Frederick E. Burdick

Name: __________________________________________________________

Street Address: ___________________________________________________

City, State & Zip Code: ___________________________________________

Telephone: (______) _______________________________________________

E-Mail: __________________________________________________________

Please send me:

Quantity ____ @ $20 each = $ ______

Total Enclosed..................$______

Send a Check or Money Order made payable to "Frederick E. Burdick" to:

Frederick E. Burdick, 595 Taugwonk Road, Stonington, CT 06378

Please remember: Proceeds in excess of production and shipping costs (US Mail) will be contributed to The Avery Memorial Association. If you have any questions, please phone Fred at 860-535-8454 or e-mail him at fburdick@comcast.net