Professional Care 2015/16 Catalogue

Service
Fax order form
FAX Germany: +49 (0) 8654 48 87-55
I/We order the following item(s) in accordance with your delivery and payment terms:
Item name Item number Quantity Unit price / €
Orders of a net value of €150.00 or more are delivered free of charge to addresses in Germany and Austria.
A surcharge of €5.00 applies to orders worth less than €50.00.
Customer number:
Name:
Company:
Street:
Phone:
Internet:
Date:
Country:
Postcode / town or city:
Fax:
E-mail:
Signature: