Order form for the 'Care & Breeding of the Golden mantella' Book

ORDER FORM
The Golden Mantella Handbook
by Marc Staniszewski

[FrontPage Save Results Component]

REF: GOLDMANT01-WEB-Feb-2001

Please complete the following form and post by snail mail to the address at the bottom of your form along with your cheque or international money order. Alternatively bank wire can be arranged. Please email me for further details on this procedure.

Personal Details
Title
First name
Last name
Address: Street Name 1
Address: Street Name 2
Address: Town/City
Address: County/State
Address: Zip/Post Code
Address: Country
Address: Other Country
Phone number

Email address (if applicable)


Ordering Details
How many copies of the book are you ordering:
Denomination
Other Denomination
Total cost of books being ordered (see table on golden mantella book page)

Once completed please send your order (completed order form and cheque) to the following address if outside the USA and Canada:-		Mantella Book Order 56 Baldwin Road Kidderminster Worc's DY10 2UA England, UK
Cheques/Checks should made payable to:-		M.S.Staniszewski

or in the USA and Canada:-		Mantella Book Order 1038 N.Lightner Wichita KS 67208-2747 USA
Cheques/Checks should made payable to:-		J.Ehrstein