Order Form:
For your convenience - once you have opened
this page, keep it open
(in its separate window) while surfing
through the site.
You can print this form, fill it by hand
(CAPITAL LETTERS) or any HTML editor,
and send it to the fax number: 972-2-6221127
or mail it to our address.
Customer Details:
First name:
Last name:
Mailing address:
City/State:
Zip Code:
Country:
Phone at home:
Phone at work:
Fax Number:
Email:
Order:
Name or Catalog number:
Price for single item:
Quantity:
Name or Catalog number:
Price for single item:
Quantity:
Name or Catalog number:
Price for single item:
Quantity:
Name or Catalog number:
Price for single item:
Quantity:
Name or Catalog number:
Price for single item:
Quantity:
Name or Catalog number:
Price for single item:
Quantity:
Total order in $:
Credit Card Details:
Credit Card Company:
Number:
Expiration date:
Name of card owner:
Important Details:
*Delivery - By "First Class Air Mail"
and takes up to 9 days from the day of the delivery.
*Responsibility - We take responsibility
that the product arrives to you safely.
*Keeping your details private - We keep
all the information that we receive discreet.
*Further information or questions - Please
e-mail us and you will be answered the day after.
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Signature