Fax Order Form

Instructions:

This order form may be sent by fax from the UK to 01624 835 400, or outwith UK +44 1624 835 400 or may be used to enclose with your cheque. Simply print it out, fill it in and send it to us. If the form is not long enough, carry it forward to a second print-out.

For bulk orders (three books or more), please ask at sales@elchempub.com for a quotation (or call +44 (0)1624 834 941) for Post & Packing and possible quantity discounts before submitting this form.

Please consult our country-sensitive price list which will automatically calculate the appropriate currency and postage rates.

Cut along line below:

Code	Title	Qty	Unit Price	P&P	Total












Sub-Total


Name		Position
Company
Street address
City		State
Country		Post/ZIP Code
Order no.		Order date
Telephone	+	Fax	+
E-mail
Payment (underline)	Cheque/ Visa/Mastercard/Eurocard
	Card no.
	Card expiry date
	Card Security Code (last three digits on back of card)
	Card holder's name as shown on card
VAT number (EC countries only)		Currency (underline)	Pounds Sterling/US Dollar

Sub-total from above
VAT @ 17.5% (if applicable)
TOTAL PAYMENT

Date:

Signature:

If Paying by Cheque

UK Orders: cheques must be raised on a British bank and payable in UK pounds sterling.

Rest of the World: cheques must be raised on a United States of America bank and payable in US dollars.

From UK - Fax # for submission of this form: 01624 835 400
Outside UK - Fax # for submission of this form: +44 1624 835 400

Address for sending this form with your cheque, if appropriate

Electrochemical Publications Limited
Asahi House
Church Road
GB-Port Erin IM9 6AQ

Fax Order Form

Instructions:

From UK - Fax # for submission of this form: 01624 835 400 Outside UK - Fax # for submission of this form: +44 1624 835 400

On no account transmit your credit card details by the Internet: it is not secure!

From UK - Fax # for submission of this form: 01624 835 400
Outside UK - Fax # for submission of this form: +44 1624 835 400