"Formal Order Form" for Zen Art Originals. 

(For Zen Art Originals Only.)   

For Orders by Fax or Regular Mail. 

Formal Order Form of PDF

　
<To:>Jikyu-an Zen Art.
23-3 Kitsujiminami-cho, Hanazono, Ukyo-ku, Kyoto. 616-8057 Japan.
Phone: +81 75 462 1370  
FAX: +81 75 461 7990 
e-mail:< zen-art@jikyu-an.com>

Zen Art ID No:

Name of Artist:

Text:

Price:

　
　
　
　
　
　
　
　
　
　
　
　
Name: (Please print in block letters.)

　

 Address:
Signature: ZIP Code: Country:
Date:
Phone: Fax:
E-mail Address:

Please select method of shipment.

1. EMS 2. SAL Air Mail 3. Surface Mail

Please select method of payment.

1. Bank Transfer 2. International Postal Money Order 3. Credit Card

For credit card orders, please provide the following information.

Name of the cardholder:                                                   Card name:
Card number: (              -               -              -               )  Expiration date: (     month/      year)
Comments or Messages to Us:

　

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