Order book Form

Your order will be shipped via postal mail. For this we need the following information:

Title	Mr Mrs
First Name
Last Name
Title
Company
Street Address
Address (cont.)
Zip/Postal Code
City
Country
Work Phone
FAX
E-mail
VAT*	If not filled out we have to charge you 19% (Dutch) VAT*
*	Only for companies in the EU

Shipping	if other then above
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Billing	please select payment preference
Credit Card	VISA MasterCard American Express Select One
Card details	Fax card number, name of credit card holder, expiry date and cvc code to PLCopen +31 183 664821
Bank transfer