Order Form for "Craft Products and Prints".

For orders by fax or regular mail.     

   Order Form of PDF   

 

<To:>Jikyu-an Zen Art.
23-3 Kitsujiminami-cho, Hanazono, Ukyo-ku, Kyoto.
616-8057Japan.
Phone: +81 75 462 1370   FAX:  +81 75 461 7990 
E-mail: <jikyu-an@mbox.kyoto-inet.or.jp>

ID No:

Description:

Quantity:

Unit price:

Subtotal:

         
         
         
         
         
Name: (Please write your name in block style.)

 

Address:
Signature: ZIP Code: Country:
Date:
Phone: Fax:
E-mail Address:

Please select method of shipment.

1. EMS 2. SAL Air Mail 3. Surface Mail

Please select method of payment.. 

1. Bank Transfer 2. International Postal Money Order 3. Credit Card

For credit card orders, please provide the following information.

Name of the cardholder:                                                   Card name:
Card number: (                 -                 -                -                 )  Expiration date: (     month/      year)
Comments or Messages to Us:

 

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