• by regular mail: print Order Form and mail to publisher's address (see below); enables payment by check or credit card
• by fax: print Order Form and send by fax to the publisher's offices at Brookfield, VT (Fax:802-276-3837) or Rotterdam (Fax: +31-10-4135947)
• by e-mail: "copy" Order Form (below) into e-mail message to the publisher's Brookfield, VT office: info@ashgate.com
• from your bookseller or bookstore

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ORDER FORM

E. VanMarcke: Quantum Origins of Cosmic Structure, Balkema Publishers, 1997.
Only available in: Hardcover, ISBN 90-5410-674-3, $65.00; Paperback (ISBN 90-5410-678-5) first printing sold out.

Number of copies ordered:

____ Hardcover, at $65.00 per copy

Price in British Pounds: £36; individuals living within the E.C.need to add 6% VAT

Payment by personal check drawn on a bank in the U.S. or the U.K.
or by credit card (Circle one): Master Card / VISA / American Express / Diners / Eurocard / JCB

Card number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _

Expiration Date: _________ Signature: ___________________________

Name: _________________________________________________

Address: _______________________________________________

City & Country: _________________________________________

E-mail Address (Optional): _________________________________

• A.A. Balkema Publishers, P.O. Box 1675, NL-3000 BR Rotterdam, Netherlands, or
• For USA & Canada: A.A. Balkema, Old Post Rd., Brookfield, VT 05036-9704

or fax it, or copy/paste into an e-mail message, to info@ashgate.com