This page allows you to order our publications in a secure and easy way. If you require assistance or have any queries, don't hesitate to let us know: lombregt@compuserve.com -

Fill in this order form, print it, sign it and

fax it to : +32(0)51687712

or send it to: Ombregt vof Kanegemstraat 170 8700 Tielt / Belgium

you can also make an order by phone: +32/51689995 or by E-mail: lombregt@compuserve.com

Products, together with the invoice will be shipped by Ombregt vof within two weeks upon receipt of payment.

Yes, I would like to order the following CD-roms at the price of 150 euro

Product Information

Select product     ----------------------- A System of O.M.( 195 Euro) Atlas of Orthopaedic Examination( 26 Euro) Postage and Packing     ----------------------- Europe 18 Euro Outside europe 27 euro Total to pay:

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Payment by Credit Card     Please note that if you wish to pay by credit card, you must print out this form, sign and date it and fax it/send it by mail to Ombregt vof. All credit card orders are accepted via Europabank , Burgstraat 170, B-9000 Gent. I hereby authorize Ombregt vof to bill my credit card for the summ of: :   USD USD VISA MasterCard Card Number Expiration Month 01 02 03 04 05 06 07 08 09 10 11 12   Year 1999 2000 2001 2002 2003 2004 Payment by Cheque     Please note that if you wish to pay by cheque, you must print out this form and send it with your cheque by mail. Yes; I would like to pay by cheque and I attach a cheque ( made payable to Ombregt vof) in the summ of: Date and signature: (The date and your signature are essential when paying by credit card)