Please print and fill this order form, then send it by mail to:
Roberto Silva Santisteban
Jr. Garcilaso de la Vega 2574
Lince, Lima
Peru
Tel: (51-1) 440 3972
E-mail: rosilsa@terra.com.pe
| Qty. | Description | Color | Size | Price in US$ |
|---|---|---|---|---|
| Prices subject to change without notice | Total Price of Items |
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Shipment Information
Name_____________________________Company___________________________
Street________________________________________________Apt.____________
City_______________________________State______________Zip_____________
Phone____________________Fax_________________E-mail__________________
Payment Information
Check/money order in US$ only, payable to "Roberto Silva Santisteban"
All payments must accompany order form.
Question?
Please contact the Office of Public Information
Tel.: (202) 974-3878 Fax: (202) 974-3143
Email: centennial@paho.org
Please allow six to eight weeks for delivery