TIG BHRÍDE, 91 BÓTHAR BHINN ÉADAIR, BEANN ÉADAIR, BAILE ÁTHA CLIATH 13,
ÉIRE
FÓN: 00353 (0)1 83 22 509
FAICS: 00353 (0)1 83 20 131
coisceim[a]coisceim.ie
COISCÉIM, LEABHAIR DEN SCOTH
91 BÓTHAR BHINN ÉADAIR,
BINN ÉADAIR, FACS: 00353 (0)1 83 20 131
BAILE ÁTHA CLIATH 13 FÓN: 00353 (0)1 83 22 509
ÉIRE
Ordaithe le Cártaí Creidmheasa téigh chuig: www.litriocht.com
Credit Card orders, log onto : www.litriocht.com
FOIRM ORDAITHE / Order Form
AINM AN LEABHAIR:____________________________________________
Book Title
ÚDAR:_________________________________________________________
Author
BLIAIN NÓ UIMHIR FOILSITHE:__________________________________
Year of Publish or Book Number
MÉID CÓIPEANNA:_____________________________________________
Amount Required
MODH ÍOCAÍOCHTA:_SEIC: ORDÚ PHOIST: AIRGEAD TRIM:
Payment Method : Cheque Postal Order Cash
MÉID: € . . . . . . . . .
Amount
POSTAS: €2 don leabhar.
Postage €2 Per Book
IOMLÁN: € . . . . . . . . .
Total
AINM:_________________________________________________________
Name :
SEOLADH:_____________________________________________________
Address :
_______________________________________________________________
_______________________________________________________________
UIMHIR GUTHÁN:______________________________________________
Phone Number :
Priontáil agus Líon amach an fhoirm seo, le do thoil, agus seol ar aghaidh é chuig an seoladh thuas ar bharr le do mhodh íocaíochta. Ba chóir go mbeadh do rogha leabhair ar a slí chugat laistigh de choicís.
Print out and complete this form please, and forward it to the address above along with your payment. Please allow a fortnight to receive your choice of books. Thank You.
