Orderform Antiquariaat Gemilang

Antiquariaat Gemilang
P.O. Box 26, 7126 ZG Bredevoort, The Netherlands. Tel. (+31)[0] 543 452325 Fax. (+31)[0] 543 452300

Back to homepage Your field of interest E-mail: gemilang_antiq.booksellers.nl@planet.nl

Orderform

Please fill in the number, title and prize of the book(s) you would like to order. To make things easy: use the edit-function of your browser and copy the book(s) you would like to order from the cataloque and paste them into this form. To do this: Select the text of the book you want to order with your mouse, press "Ctrl C", put your cursor in the text-area below and press "Ctrl V"

Payment by following credit cards accepted: AMEX/DINERS/VISA/JCB.
When ordering kindly state cardtype, number and expiry date.
VAT No.: NL 062. 645.201 B01

I want to order the following books:

Name :

Address :

ZIP code :

City :

Country :

Phone :

Fax :

E-mail :

Method of payment:

Charge my creditcard Visa Amex Diners JCB

Card number :

Expiry Date:

I will pay your proforma invoice by: Bank Check International Postal Money Order On Your Postal Giro Account

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Name :
Address :
ZIP code :
City :
Country :
Phone :
Fax :
E-mail :

Method of payment:
*Charge my creditcard*	Visa Amex Diners JCB
Card number :
Expiry Date:

*I will pay your proforma invoice by:*	Bank Check International Postal Money Order On Your Postal Giro Account