"Formal Order Form" for Zen Art Originals.
(For Zen Art Originals Only.)
For Orders by Fax or Regular Mail.
<To:>Jikyu-an Zen Art.
23-3 Kitsujiminami-cho, Hanazono, Ukyo-ku, Kyoto.
616-8057 Japan.
Phone: +81 75 462 1370 FAX: +81 75 461 7990
E-mail: <[email protected]>
Zen Art ID
Name of Artist:
No:
Text:
Name: (Please print in block letters.)
Address:
Signature:
ZIP Code:
Price:
Country:
Date:
Phone:
Fax:
E-mail Address:
Please select the
1. EMS
2. SAL Air Mail
3. Surface Mail
method of shipment.
2. International Postal
Please select the
3. Credit Card
1. Bank Transfer
Money Order
method of payment.
For credit card orders, please provide the following information.
Name of the cardholder:
Card number: (
Card name:
-
-
Comments or Messages to Jikyu-an:
-
) Expiration date: (
month/
year)