---

ODEME EMRI / MAIL ORDER FORM
Lutfen formu doldurup fakslayiniz: +90.312.425 93 77, ya da postalayiniz.
Please fill in and fax : +90. 312. 425 93 77 , or mail to.

Lütfen satin aldigim kitaplarin bedeli olan ..............................................TL'yi Kredi karti hesabima alacak kaydediniz.
Please charge from my credit card account the sum $ / € ....................... for the books I have purchased.

VISA MASTER CARD EUROCARD

Kart No / Card Number:

Son Kullanma Tarihi / Expiriling date (month/year) :

Güvenlik Kodu (CVC2) / Security Code
(Three-digit security code printed on the back side of bank card, right after the account number):

Adi / Soyadi
Name / Surname :

Adres / Address :

Telefon / Phone :

Faks / Fax :

E-posta / E-mail :

Imza / Sign :