O
RDERING FORM
Fill in the order form. Print it and mail or fax it to us.
If you want to delete the entire text, Click on the button
"Delete all"
.
Last name:
First name:
Postal address:
Postal Code:
City:
Country:
Company/org:
Org.no:
Phone:
Mobile phone:
Fax:
e-mail:
Quantity:
Order No:
Description:
Price each:
Total:
Tick one:
VISA
MASTER CARD
DINERS CLUB
Card number:
Expiry date:
Leksands Hemslöjd
Box 70
S-793 22 Leksand
SWEDEN
Phone: Int+46247 10046
Fax: Int+46247 34948
E-mail:
hemslojden.leksand@telia.com
Bankgiro: 796-2517
Postgiro: 963 80-1