Birgit Lotz Verlag

Order Form

First Name:
Last Name:
E-Mail Address:
Address:
Address:
City:
State:
Zip Code:
Country:
Home Phone:
Work Phone:
Home Fax:
Work Fax:
If you would like to pay for your order by Visa/Mastercard, please provide the following information:
Visa/Mastercard Number:
Expiration Date:
Shipping Address (if different)
First Name:
Last Name:
Address:
Address:
City:
State:
Zip Code:
Country:

Item/Title	Quantity	Price

Payment

Payments, net without discounts or deductions, may be made by postal money orders, travelers checks, cash (registered mail, please), Visa/Mastercard, or checks drawn on German banks. All payments must be made in Euro.
Our bank account: # 415091500 Postgiro Koeln , BLZ: 37010050 , IBAN: DE13370100500415091500 , BIC: PBNKDEFF

Shipping

Orders will be shipped via the Post Office by surface or airmail, at the customers request. Since shipping charges vary by weight and destination customers will be invoiced separately, unless customers submit a credit card number with the order. Foreign shipments will be declared at full retail value. Insurance is optional at cost, but the purchaser assumes risk for loss or damage for uninsured shipments.

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Once you have completed filling out this order form, click here:

This form will be e-mailed to Birgit Lotz Verlag.
For added security you may alternatively fax this form to +49-228-365142

Contact:
Rainer E. Lotz
Rotdornweg 81
53177 Bonn, Germany

Phone(International): +49-228-352808 / Phone(National): 0228-352808
Fax (International): +49-228-365142 / Fax (National): 0228-365142
E-Mail: disc@lotz-verlag.de

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