“LIZKOR”
PHOTOGRAPHY / FOTOGRAFIE
BESTELVORM / ORDER FORM
Tel: 072 654 0274 / Fax: 0866 576 415
http://lizkor.jalbum.net
E-mail: [email protected]
Name ____________________ __________________________________
Tel: ________________________________________________________
Postal Address ________________________________________________ Relive
the moment!
E-POS ADRES / E-MAIL ADDRESS ___________________________________________________________
Photo
Number
10X15cm (Jumbo)
A5 (13X17.5cm)
A4
R 30.00
R 50.00
R 80.00
Postage/ Posgeld (Indien van toepassing / when applicable)
TOTAAL / TOTAL
R 30.00
BETAAL / PAID
Bestelling moet deur elektroniese betalingsbewys vergesel word.
Order must be accompanied by proof of electronic payment.
Acc details/ Rek nr: AJ PIENAAR – 01 793 951 8 - Standard Bank – Pta Noord – 10445
Please fax proof of payment to Fax nr 0866576415 OR send me an e-mail
Dankie vir u ondersteuning. / Thank you for your support.
Kobus

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