Your shopping cart: (all prices are VAT inclusive)

Shipment calculated to:

Please fill in the following form. Press 'Send your order' when finished.
mandatory fields *
Your personal information   
Name and surname: *
Company:
Vat number/Tax code:
Address: *
Zip code: *
City (State): *
 
Shipping address (if different):
Ship to:
Address:
Zip code:

City (State):

 
e-mail: *
* Telephone:
* Please let us know your telephone number should we need to contact you
 
  Remember my data on this computer
Next time you will place an order this form will be automatically filled in with your data
Clear data memory
 
Payment method:
Beneficiary: C. Holmes, Den hulst 84, 7711 GR Nieuwleusen
Bank: ING Hoogeveen, Hoofdstraat 94, 7901 JT Hoogeveen
ING Bank international code: INGBNL2A.65.58.70.105
(You will also receive these details in your Order Confirmation email)

Please, send proof of payment specifying your order number:
by fax +45 23 2554221
by email tellab@xs4all.nl
 
Notes:

I am 18 or older


(please press once and wait for the server to answer)