Neelwafurat.com - Order Form
Please fill the order form and fax it to the number 009611786230 or you can alternatively send it to the following address: Arab Scientific Publishers, Reem Bldg-Ain el-Tinah, P.O.Box 13-5574, Beirut-Lebanon.
1. Shipping information: |
Full Name: | |
e-mail address: | |
Shipping Address: |
Telephone Number(s) with country code and area code: |
Phone#: | |
Mobile#: | |
Fax#: |
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Choose one: | Certified
Cheque
Visa Card Master Card American Express |
If paying by credit card, please indicate the following: |
Credit Card Number: | --- (up to 16 digits) |
Expiry date: | Month Year |
Full Name of Card Holder: | |
Mailing address as known to your credit card company): |
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Signature of Card Holder: |
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Choose one: | Registered Mail Fast Mail |
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