electronics  •  writing instruments  •  pendrives  •  general information 
 
Bardzka 30, 50-516 Wroclaw, Poland, tel: +48 71 336 8669, fax: +48 71 336 8665, e-mail: miromktg@wp.pl
    SAMPLES ORDER FORM  
   
company name:   
contact person:   
address:   
NIP:   
mailing address:   
(if other than above)    
phone number:   
e-mail:   
samples to chose from:

 
item code:   
remarks:   
Samples will be send by POCZTA POLSKA collect.
If you prefer to use your carrier please specify it in remarks.