*** PLEASE PRINT AND FILL OUT FORM ***
               

             40th ANNIVERSARY COMMEMORATIVE EDITION OF 
      "JOHN PENTON AND THE OFF-ROAD MOTORCYCLE REVOLUTION"
                         BOOK ORDER FORM


Name _____________________________________________________________

Address __________________________________________________________

City ________________________  State _____  Zipcode ______________

Phone Number _____________________________________________________  

Email ____________________________________________________________


Price:  $ 25.00      
Free Shipping & Handling    

                                 
Qty _________ x $ 25.00 = $______________              


Make check or money order payable to PENTON OWNERS GROUP.
US FUNDS ONLY PLEASE.  


Send form and check or money order to address below.  


Penton Owners Group
P.O. Box 756
Amherst, Ohio 44001