Bookstore Fax Order Form

This form will NOT send your credit card information over the Internet. It will simply allow you to print out a neat, typed authorization form, sign it and fax it to us. Please contact us at travel@costarica.net if you experience any difficulty.
We accept Visa credit cards only.

CREDIT CARD FORM, FOR THE EXCLUSIVE USE OF
Costa Rica's Travel WEB

Card Holder Name:
Card Number:
Expiration Date:
Telephone:
Fax:
E-Mail IMPORTANT!
Shipping Address:
Billing Address:
(if different from shipping address)

Please enter the quantity of each book you wish to purchase:

Golden Door to Retirement and Living in Costa Rica $17.95
Living & Investing in the "new" Cuba $24.95

Subtotal:
Tax (13%):
Shipping ($3 per item):
Total:

I hereby authorize the recipient of this form to charge my credit card to purchase the books indicated above.

X


Authorized Signature and date

Fax any time to country code 506, fax number 255-0614
(From U.S. & Canada dial 011-506-255-0614)

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