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		Name: Street: Town: State: ZIP: Country: e-mail: Payment: VISA/Master/Amex Personal Check from a US Bank We accept VISA, Master and American Express Cards Credit Card valid through: / (month / year) enter your order and price here:
	Payment: Credit Card: Visa/MasterCard/Amex (will be billed in Euros - 1 Euro = approx. $1.15, exchange rates may vary.) Credit card info may also be faxed to: 011 49 6174 63738 OR by US Bank Check (make check payable to "Colette Hornig") Colette Hornig c/o Margaret Mooney 612 Grange Street Wilmington, NC 28411-7356