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| Name: | ________________________________ |
| Address: | ________________________________ |
| ________________________________ | |
| ________________________________ |
| Author/title: |
Price (Euros) |
| ______________________________________ |
________
|
| _________________________________________________________ |
____________ |
| ______________________________________ |
________
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| ______________________________________ |
________
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| ______________________________________ |
________
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SUBTOTAL
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____________
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| EXTRA CHARGES (Euros) | |
| Postage and packaging: European Union |
9,00
|
| Postage and packaging: rest of the world | actual postage |
| Extra charge for registered mail within Europe |
10,00
|
| Extra charge for registered mail outside Europe |
10,00
|
| Clearing charge for foreign giro transfers |
7,00
|
| Clearing charge for foreign bank cheques / foreign bank transfers |
20,00
|
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TOTAL
|
____________
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| Please indicate your method of payment: |
| ___ | I have transferred the amount to your postal giro account (5553171), and added 7,00 euros extra for clearing costs. |
| ___ | I have transferred the amount to your bank account (IBAN: NL49ABNA0540376493; BIC: ABNANL2A). |
| ___ | I have enclosed a bank cheque and added 20,00 euros extra for clearing fee. |
| ___ | I wish to pay by Visa, American Express, or MasterCard/EuroCard.
Credit card payments incur no extra bank charges.
My card number is: ________________________ Expiry date: _______ Security Code____ |
| Signature: ____________________________________ |
| INTERMALE does not accept responsibility for damage or loss of goods in transit. All prices are subject to change without notice. |