If you want to order the book please fill out this form, print it and send
it together with your payment to:

PASSION PRINT
POSTBUS 10531
1001 EM AMSTERDAM
THE NETHERLANDS

Within Europe the book costs FL. 40,- Dutch Guilders, outside Europe it
Costs FL. 50,-(all prices Incl. P&P)
10 % will be donated to Amnesty International.

To pay enclose: a eurocheque (should be in Dutch Guilders!!), 
a bankcheque (only if you live in the Netherlands), 
a postal money order (also only in Dutch Guilders) 
or your VISA card number. 

Unfortunately NO other credit cards accepted.

DO NOT SEND CASH !!!!!!!

-----------------------------

PLEASE SEND .... COPIE(S) OF THE BOOK TO:

NAME		

ADDRESS		

POSTCODE	

CITY		

COUNTRY		

TEL.		

E-MAIL		

I enclose cheque to value of ........ Dutch Guilders

Alternatively:

PLEASE CHARGE THIS VISACARD

CARDNUMBER:

NAME ON CARD:

EXPIRY DATE:

CARDHOLDER'S SIGNATURE:

(PLEASE ENCLOSE CARDHOLDER'S ADDRESS)