Order Form
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GDP-Light Order Form  

Your name:        ____________________________________________________________
 

Address:            ____________________________________________________________

                         ____________________________________________________________

Country:            ____________________________________________________________
 

Phone/Fax:        ____________________________________________________________

E-mail address:  ____________________________________________________________
 
 

GDP-Light EUR 75.00
Shipping and Handling EUR 5.00 +
    --------------
Sub-total     EUR 80.00
EU-residents add 19% VAT (EUR 15.20) EUR +
--------------
Total     EUR

Method of payment (please check one):

(  ) Visa                  Card Number:
(  ) American Express       Exp. Date:
(  ) Paypal paypal@aed.nl Safety Code:  last three digits on the strip on the back of the card
(  ) Wire transfer  Signature:

Fax this form to AED:  +31-40-2413306

Or send it by (e)mail to:  AED, Bertelindislaan 3, 5581 CS Waalre, The Netherlands,

Reg. Nr. KvK Eindhoven     17105231
VAT No.                                  NL806841886B01
ABN-Amro Bank Waalre (guilders account) 51.49.07.193