“THERE IS A HORSE IN MY KITCHEN” by Mariette Withages
Published by Fondazione Emilio Bernardelli  ISBN 9788895103013

HOW TO ORDER THE BOOK:
•	Website: www.fondazionebernardelli.it Phone: +39.02.99.038.214
•	Payment by Credit Card
•	Website: www.amazon.it
•	Payment by Credit Card
•	E-mail: segreteria@fondazionebernardelli.it or Fax No. +39.02.99.038.496
(Please, complete and send this order form selecting one of the payment methods listed below)
•	Credit Card (please, complete and send the Credit Card payment form)
•	Post Office Account No. 45825254 in the name of Fondazione Emilio Bernardelli
•	Bank Transfer IBAN IT60U 03069 33521 000019425119 		BIC: BCITITMM

ORDER FORM
Shipping address:
Mr./Ms.:_________________________________________Phone_____________________________
Address:___________________________________________________ Post Code:______________
City:___________________________________Province:_______________Country:_____________
Unit Price Euro 49,00 (from 3 to up Euros 45,00 each)		No. of copies: ___________________
*Shipping charge see details below 				Total Euro_______________________
Billing address: (if other than the shipping address)
Mr./Ms./Messrs.:____________________________________________________________________
VAT code:_________________________ Tax ID__________________________________________
Address:_______________________________________________ Post code:__________________
City:________________________________Province:_______________Country:________________
Date:___________________ Legible signature:___________________________________________
*Shipping charge:
			Europe/Mediterranean		Rest of the world
1 or 2 copies 			€ 13,50				€ 27,50
3 copies			€ 18,00				€ 35,10
4 copies			€ 27,00				€ 50,30
5 copies	 		€ 36,00				€ 65,50
6 copies			€ 45,00				€ 80,70
7 copies			€ 54,00				€ 95,90
8 copies			€ 63,00				€ 111,10
9 copies			€ 72,00				€ 126,30
10 copies			€ 81,00				€ 141,50
Please contact us if you should have any enquiries with your order or payment.

CREDIT CARD PAYMENT FORM
(for orders received by e-mail or fax)
Please, return this form completed and signed to:
fax +39.02.99.038.496 - e-mail segreteria@fondazionebernardelli.it

Surname and first name of the Credit Card holder:
__________________________________________________________________

Card		|__| Visa	|__|Mastercard	|__|Amex	|__| Diners
Card number 	|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Expiry date (month and year) |__|__|__|__|	Security code |__|__|__|
Amount in Euro |__|__|__|,|__|__|
Amount in words:____________________________________________________

I, the undersigned, hereby authorize the payment with this credit card to Fondazione Emilio Bernardelli for the purchase of the above book. I also consent to the processing of my personal data exclusively for the purposes stated herein, in compliance with Article 13 of Italian Legislative Decree No. 196 of 30 June 2003.

Date ______________

Legible signature: _____________________________________________________