[The following form was inserted loose into the booklet. It was to be used to get a price quotation from D. D. Cottrell for a particular combination of new and renewal subscriptions.]
No. _______________________ Date_______________________
COTTRELL'S SUBSCRIPTION AGENCY, NORTH COHOCTON, N.Y.
Gentlemen:—
I (including my family) am now a subscriber to the following publications which were ordered from
Name ________________________________________________________
Address _____________________________________________________
If any subscriptions were sent direct to the publishers, state which ones.
Names of Periodicals now taken Month of Expiration
Names of Periodicals I (including my family) expect to take about (give date)
I have placed "R" after each periodical I (or my family) intend to renew.