BERELIJN
Voorstraat 269
3311 EP Dordrecht
Holland
Fax:     +31 (0)78 631 04 98
Phone: +31 (0)78 631 80 28 

This order form is still under construction.
Please fill it out and than fax it to us on
*31 78 6310498


email: berelijn@planet.nl

Name  
Address  
 
 
Zipcode    City        
County
Country  
Order form
Quantity Description           Price
         
       
       
        
SAMPLECARD ON ALL OUR MOHAIRS; PRICE 10,00 (THIS PRICE IS INCLUDING SHIPPING) 10,00
  Total

        

FREE CATALOGUE ON SUPPLIES; English    German    Dutch  
Payment  
Creditcard        I have ordered before; my credit card information is on file  
Number  
Expire Date                     
Security Code (last 3 digits on your card)        
I pay on German Bank account;
    
Stadt Sparkasse BadOeynhausen; 9812579 BLZ 490 512 85 Name Nelleke v.d. Berg
Dutch Bankaccount
      ING 2923701 Name: Berelijn
      Iban: NL86INGB0002923701
      Bic: INGBNL2A
Paypal
   
My paypal emailaddress is:
    

    Confirmation email address:
    

 
Remarks