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580 Fifth Ave.     JANUS TRADING INC.     New York, N.Y. 10036
                    
Order Form 
FAX: (212) 302-4826
Print and Fax First Page of Order Form

Your Name

Your E-Mail

Your Address (apt/zip code)

Your Tel/ Fax #

Enter Merchandise Name 

A Proforma Invoice including shipping charges will be sent for 
your approval by choice of either E-Mail or Fax.  
   
Please select                     Fax            E-Mail
                                       
Select Credit Card            Visa            Master-Card
   
Credit Card Number             
Expiration Date                           
Signature

COMMENTS AND SUGGESTIONS 


                           DIRECT PAYMENT METHOD

Upon confirmation of remittance your order will be sent immediately.

The Chase Manhattan Bank  
401 Madison Avenue
New York, N.Y. 10017  U.S.A. 

ACCOUNT NAME
Janus Trading Inc.
580 Fifth Ave. Suite 2910
New York, N.Y. 10036  U.S.A.

ACCOUNT #005038235

Routing  #021000128 



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