Please print this order form, fill it out, and enclose it with your bank draft or money order, so that we can properly direct and acknowledge your contribution.
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Make out your bank draft or money order to: Paulo and Alexandra Correa. |
Send it to: Akronos Publishing 42 Rockview Gardens Concord, Ontario L4K 2J6, Canada |
Amount of Contribution ____________________________
Name of Contributor __________________________________________________
Street or PO Box: __________________________________________________________________
City: _____________________________________________________
State or Province: ____________________________ Zip or Postal Code:____________________
Country: _____________________________________________________
Telephone: Day ____________________________ Night _________________________
Email: _____________________________________________________
Additional Directives or Comments: