Nordic HF Proceedings supplementary form required for all credit card orders.
Thank you for your order. After having submitted the web order form,
please either:
- print,
fill out and fax this form to Combitech AB,
Fax no.: +46 470 420 42
OR
- print, fill out, scan to image/PDF file and e-mail this form to: info@nordichf.org
Order for Nordic HF Proceedings. Check one option: [_]CD-ROM, all conferences 86/89/92/95/98/01/04/07/10. Enter number of discs: _____ [_]Original conference binder(s). Enter selected binders (years): __________________
Check and enter the total order amount in one of these currencies: [_]SEK (each CD/binder 1400:- ) : _________ [_]EURO (each CD/binder 150:- ) : _________ [_]USD (each CD/binder 200:- ) : _________
Note that Swedish VAT (+25 %) will be added to
the total order amount above for
all orders within
Sweden.
For orders within the EU (outside Sweden) the VAT will be added if no valid VAT number was
entered on
the web order form, or enter now on this form. For orders outside the EU, VAT
will not be added.
Enter
VAT
number when applicable as above: ___________________________
Please charge my credit card with SEK/EURO/USD: ___________ ( please add 25 % VAT when applicable )
Check type of credit card: [_]EuroCard* ------------| Check two additional boxes below for an affiliated* card only: [_]MasterCard* ----------|--[_]Swedish Bank card: [_]VISA* ----------------| [_]Cash OR [_]Credit
Enter card number (printed number on card): __________________________________
Enter card expiration date (printed date on card): ___________________________
Enter name of card holder (printed name on card): ____________________________
Signature of card holder (your signature on back side of card):
________________________________ Date of order: ______________
Full address for postal delivery of your order: [_] Address is equal to the web order form.
OR
[_] Use full address entered here:
__________________________________
__________________________________
__________________________________
__________________________________
END OF FORM