Glass Service

I am interested in the Glass Defects book.

Name:

Company:

Address:

Telephone:

Telefax:

E-mail:

Billing address:

as above

Item	Pcs	Price
Glass Defects book	*	€ 300
Shipping and handling costs within Europe *		€ 20
Shipping and handling costs outside Europe *		€ 30
* The book will be sent via standard mail service.	Total:

I will pay with:

Account / Bank transfer

Eurocard/Mastercard

Visa-Card

Diners-Card

3-digit security code:

Credit card No.: valid until:

Owner: