Diskus Brief - Fax/Mail In Order Form

Diskus Brief, The International Discus Journal
Curt Kafer, Publisher - Diskus Design
28180 Verdin Street N.W. Isanti, MN 55040-6030
(763)444-6029 ~ Fax: (763)444-5032 ~ Curt@diskusdesign.net

All orders will be verified prior to shipment.

Qty
Country
Shipping

Total

United States
$ 5.00

$ 55.00

Canada, Mexico
$ 9.00

$ 59.00

Aruba, Australia, Austria, Bahamas, Barbados, Belgium, Brazil, Caicos Islands, Chili, China, Colombia, Corsica, Costa Rica, Czech Republic, Finland, France, Germany, Great Britain, Guyana, Hong Kong, Hungary, Iceland, India, Ireland, Israel, Jamaica, Japan, Korea, Liechtenstein, Luxembourg, Malaysia, Monaco, Netherlands, New Zealand, Norway, Philippines, Poland, Portugal, Saint_Lucia, Saudi_Arabia, Singapore, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Tobago, Trinidad, Turk Islands, Vietnam
$ 11.00

$ 61.00

First and Last Name:

Telephone:

Street or Mailing Address:

Fax Number:

Street or Mailing Address:

Email Address:

City and State/Providence or Country:

Zip/Postal Code:

Visa / Master Card (Circle one) Expiration Date: ___/___

Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ CSV: _ _ _

Full name as it appears on Card:

Print and complete this form. Fax or send with payment to Curt Kafer, Diskus Design,
28180 Verdin Street N.W. ~ Isanti, MN 55040-6030 ~ 763-444-6029, Fax: 763-444-5032

Secure OnLine Order Form ~ Printable Order Form ~ Contents of Diskus Brief
Contents of 1994, 1995, 1996, 1997 and 1998

First and Last Name:	Telephone:
Street or Mailing Address:	Fax Number:
Street or Mailing Address:	Email Address:
City and State/Providence or Country:	Zip/Postal Code:
Visa / Master Card (Circle one) Expiration Date: ___/___ Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ CSV: _ _ _
Full name as it appears on Card: