|
ORDER FORM
Please print out this form, fill it in, and send it by
post to
Tomki Němec, Žitomírská 35, Praha 10, CZ-101 00, CZECH REPUBLIC
I wish to order the photographic publication
VÁCLAV HAVEL - Photographs by TOMKI NĚMEC
Price per book:EURO 17 /US$17 + Shipping
MR/MRS/MS:
COMPANY:ADDRESS:CITY:
PROVINCE/STATE:
POSTAL CODE:
COUNTRY:PHONE:FAX:
E-MAIL:
YES,I WISH TO PLACE AN ORDER!
……… copies of VÁCLAV HAVEL - TOMKI NIMEC,Photographs
DATE :
SIGNATURE :
|