THE LVIV OPERA HOUSE - BOOK ORDER FORM
www.brama.com/shop/lvivoperabook
Fax your order with credit card info to: 509-756-6230
(or)
Mail the completed form to (new address!):
BRAMA, Inc.
"THE LVIV OPERA HOUSE" Book
PO Box 20606
Tompkin Square Station
New York, NY 10009
DATE ORDERED: __________________
The Lviv Opera House
Λόβ³βρόκΰ Ξοεπΰ _______ copy(ies) x 49.00ea = $_____________
+ S&H ($8.00 in U.S.)
+ TAX (where applicable)
NOTE:
Shipping & Handling will be added to the TOTAL credit card charges.
Sales Tax 8.25% will be added to New York State shipments.
[ ] VISA
[ ] MASTERCARD _____________________________________________
Name on credit card: ____________________________________________
Exp. date: __________ Billing Postal/Zip Code: ________________
Please provide contact information in case of problems with the order:
Your telephone number: (____)_______________
E-mail ____________@________________________
SHIP TO (PRINT CLEARLY, TYPE, or USE A STICK-ON RETURN ADDRESS LABEL):
____________________________________________________________________________
NAME
____________________________________________________________________________
ADDRESS
____________________________________________________________________________
____________________________________________________________________________
CITY, STATE ZIP
[ ] INCLUDE A GIFT CARD
MESSAGE: ______________________________________________________________
THANK YOU FOR YOUR ORDER!!!
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