John Benjamins -- Subscription Form

 Please fill in this form, print it out using the print option in your browser, sign the printed form and send it by mail or fax to:
John Benjamins Publishing Company, P.O.Box 36224, 1020 ME Amsterdam, The Netherlands
Fax: +31-(0)20-6739773.

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Subscription type:
Institutional Price (EUR): For libraries, institutions and companies.
VAT-ID:        Within the EU 6% VAT will be added, unless a VAT-ID is specified.
Private Price (EUR): For private persons only, not to be made available to an institution. Within EU 6% VAT must be added.
By sending this order I accept the conditions for private use of a subscription. I declare it is for my personal use only and that it will not be put at the disposal of any library or institution. Personal rates are applicable only when delivery is made to a home address, and no company or institutional cheques are accepted. This condition applies both to the print and/or electronic version.
Method of payment:
Please send an invoice (institutional subscribers only)
I enclose a check (USD check drawn on a US bank only)
Please charge my credit card
Credit Card number Exp. date
CVC code VISA, Euro/Mastercard. The 3-digit number can be found on the back of your card, following your card number.
Signature:
 
 
Subscriber information:
Name
Mailing address:
E-mail:
Billing address (only if different from mailing address)

E-mail address for information: subscriptionbenjamins.nl

Please note that this form can currently not be submitted through a secured online connection.
We therefore kindly ask you to print out the form using the print option in your browser, sign the printed form and send it by mail or fax to:
John Benjamins Publishing Company, P.O.Box 36224, 1020 ME Amsterdam, The Netherlands
Fax: +31-(0)20-6739773.