Printer Friendly

Printed from http://www.researchandmarkets.com/reports/682139

2009 Worldwide Electronic Shopping & Mail Order Houses Report

Page 1 of 2

Printed Sunday, May 26, 2013
6:26:53 AM

Fax order form

To place a fax order simply print this form, fill in and fax the completed form to the number below. If you have any questions please email help@researchandmarkets.net

Order information

Please verify that the product information is correct and select the format you require.

Product name

2009 Worldwide Electronic Shopping & Mail Order Houses Report

Report Formats

Please enter the quantity of the report format you require.

Format	Quantity	Price
Hard Copy		EURO€ 268.00 + EUR€ 25.00 Shipping/Handling *
CD ROM		EURO€ 207.00 + EUR€ 25.00 Shipping/Handling *
Electronic (PDF) - Single User		EURO€ 191.00
Electronic (PDF) - Site License		EURO€ 344.00

* Shipping/Handling is only charged once per order.

Contact information

Please enter all the information below in block capitals.

Title:

Mr Mrs Dr Miss Ms Prof

First Name:

Last Name:

Email Address:

Job Title:

Organisation:

Address:

City:

Postal / Zip Code:

Country:

Phone Number:

Fax Number:

Please fax this form to:
(646) 607-1907 or (646) 964-6609 (from USA)
+353-1-481-1716 or +353-1-653-1571 (from Rest of World)

Page 2 of 2

Printed Sunday, May 26, 2013
6:26:53 AM

Payment information

Please indicate the payment method you would like to use by selecting the appropriate box.

Pay by Credit Card:

American Express

Diners Club

Master Card

Visa

Cardholder's Name:

Cardholder's Signature:

Expiry Date:

/

Card Number:

CVV Security Code:

Issue date:

/ (Diners Club only)

Pay by Check:

Please post the check, accompanied by this form, to:

Research and Markets,
Guinness Centre,
Taylors Lane,
Dublin 8,
Ireland.

Pay by Wire Transfer:

Please transfer funds to:

Account Number:

83313083

Sort Code:

98-53-30

Swift Code:

ULSBIE2D

IBAN Number:

IE78ULSB98533083313083

Bank Address:

Ulster Bank,
27-35 Main Street
Blackrock,
Co. Dublin
Ireland.

If you have a Marketing Code please enter it below:

Marketing Code:

Please note that by ordering from Research and Markets you are agreeing to our Terms and Conditions at http://www.researchandmarkets.com/info/terms.asp

Please fax this form to:
(646) 607-1907 or (646) 964-6609 (from USA)
+353-1-481-1716 or +353-1-653-1571 (from Rest of World)