Zamowienie / Order Form - the Polish Bookstore in Ottawa Online

ZAMOWIENIE / ORDER FORM
Wydrukowane i wypelnione zamowienie prosze wyslac faxem lub poczta do Ksiegarni Polskiej w Ottawie. Tekst
zamowienia moze byc rowniez wyslany poczta elektroniczna.
Print this form, fill it out, then fax or mail it to Polish Bookstore in Ottawa. Contents of the form may also be sent to us by
e-mail.
Date: ___________________
Name: ______________________________________________________
Address: ______________________________________________________________________________
Telephone #: ________________________________
Email: ___________________________________
Prosze przyslac nastepujace pozycje / Please send the following:
Autor/Author
Platne / Payment by:
•
•
•
•
•
VISA
MasterCard
American Express
cheque
money order
Tytul/Title
Cena/Price
Card information:
Numer / Number: _____________________________
Data waznosci / Expiration date: __________________________
Podpis / Signature __________________________
Polish Bookstore in Ottawa
7986 Parkway Road, Metcalfe, Ontario K0A 2P0 Canada
Tel/Fax 1- 613-821-3309
Comments and inquiries: [email protected]
Liczba
egz./Quantity