PURCHASE ORDER of the Circumcision Adviser (in German only)

With this I order the Circumcision Guide at cost price of 8 Euros including postage and packing.

I will transfer the money to:
EURO CIRC, account number 120 1433 00, Deutsche Bank AG, bank code number 350 700 24
From abroad:
If you don't have a German account but live in a country of the European Union:
IBAN: DE25350700240120143300; BIC/SWIFT-Code: DEUTDEDB350 (The same well-priced conditions as for national transfers)
You're from a country outside the European Union? Please send the contribution in bank notes to our address (see above). You can increase the safety by registered mail..

(Please indicate "BRG" and your name as reason for payment - allocation can not be made otherwise.)

Member name	(if existing)
Status *
Name *
First name *
Street address *
ZIP/city *
Country *
Telephone
E-mail address (we inform you with e-mail when we can send you the advisor)
* = mandatory fields