ATARAXIA ORDER FORM
date : ____ / ____ / ____
|
ITEM
|
QTY
|
PRICE
EACH
|
TOTAL
|
|
+
POSTAL CHARGES :
[ __ ] Priority [ __ ] Registered |
................................
|
|
+
6% of the total amount (Paypal payment only) :
|
................................ |
|
TOTAL :
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................................
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|
Check
off PAYMENT :
(only in Euro) |
[
__ ]
|
VAGLIA
POSTALE
|
|
[
__ ]
|
POSTPAY
|
|
|
[
__ ]
|
POSTAL
/ EURO MONEY ORDER
|
|
|
[
__ ]
|
CASH
(well hidden in a registered letter / at my own risk)
|
|
|
[
__ ]
|
WESTERN
UNION TRANSFER
|
|
|
[
__ ]
|
MONEYGRAM
|
|
|
[
__ ]
|
PAYPAL
(only in Euro to : pando@misterweb.it)
|
|
your
E-mail :
|
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YOUR
NAME & POSTAL ADDRESS :
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