Name : ____________________________ Title : ____________________________ Company Name : ____________________________ Phone# : ____________________________ Fax # : ____________________________ e-mail : ____________________________ Addr : ____________________________ City : ____________________________ State : ____________________________ Country: ____________________________ Zip : ____________________________ Language (Please Check One): [ ] Chinese [ ] Korean [ ] Greek [ ] Russian [ ] Japanese [ ] English Fee : US$35 (or £21) per Camera-ready Typeset Payment: [ ] VISA [ ] Master Card [ ] Amex [ ] Purchase Order#______________ [ ] Invoice Me Total Amt: US$______________ Card #:________________________ Expiry Date: _________ Signature: _______________________ Date: _____________ +- -+ | | Attach a Sample of your current Business Card | | +- -+Please Fax your Order to: CCSR, Fax # 1-905-567-7585
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Phone: 1-416-930-5724
Fax: 1-905-567-7585
email: ccsr@sympatico.ca