Bestellanfrage / Order request

• via email (copy this page, paste into email window, fill in your data, send / diese Seite kopieren, ins email Fenster einfügen, ausfüllen, abschicken)
• via fax: +49-(0)-2332-83998 (no zero for international calls)
• via Post:

Yes, I would like to order the following articles:
Ja, ich würde gerne die folgenden Artikel bestellen:

 Q         Art.No.          Title                          Price
 ...        LC01          Swizzle Stix                     Euro 55,-
 ...        LC02          Hollywood                        Euro 55,-
 ...        LC03          Graffiti                         Euro 55,-
 ...        LC05          Infinity                         Euro 55,-
 ...        LC06          Jeans                            Euro 55,-
 ...        LC07          I love You                       Euro 55,-
 ...        LC08          New York                         Euro 55,-
 ...        LC09          Golden Point                     Euro 55,-
 ...        LC10          Blue Clipper                     Euro 35,-
 ...        LC11          Golden Point Clipper             Euro 35,-
 ...        LC19          Blue V                           Euro 55,-
(Euro 10,- Porto & Verpackung / Package & Shipping)      + Euro 10,-

                                                Total Euro ..........

( ) Payment/Bezahlung via Paypal

( ) Bitte verrechnen Sie über meine Kreditkarte Euro ..........
    Please charge Euro .......... to my credit card:

( ) Visa     ( ) Mastercard     ( ) Diners Club

Card number ...............................................

Expiry date ...../.....

Address:    ...............................

            ...............................

            ...............................  email:
Tel.:                                        Fax:
Date:                                        Signature:

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