Polish Poster Gallery

		Order Form

You may submit your order now or print this page and send with registered letter to: Sklep-Galeria PTTK (this is the official name of our company), ul.Piwna 28/30, 00-265 Warsaw, Poland. For any questions please e-mail us.

Fields marked green MUST BE FILLED

DESCRIPTION OF ORDER:

TITLE:	Mrs. Mr. Ms
FIRST & LAST NAME:
STREET ADDRESS:
City, State: ZIP:
Country:
Phone, fax:
E-MAIL:
re-type e-mail:

DELIVERY: Standard Airmail Economy Express

Payment:
Name of cardholder:
Creditcard number:
Valid through:
CVV Number:
Additional comments:

Print a copy for your records
before submitting