
  If you are ordering by (snail)mail (cash),  international money 
  order or check, do fill in this order form and send it together 
  with the money/money order/check  in a letter  to the following 
  adress:

	   		    Imphobia a.s.b.l.
		          c/o Van Audenhove F.J.
	    	          118, Av. Du Roi Soldat
                            B-1070 Bruxelles
                                Belgium

  You do NOT need to fill in this  order form if you are ordering
  by credit card. 

---/cut here/----------------------------------------------------

[AUDIOPHONIK CD ORDER FORM]

  Date you are ordering .........................................
  Handle/Group (optional) .......................................
  E-Mail adress (optional) ......................................

  Full Name .....................................................
  Full Address ..................................................
  ...............................................................
  ...............................................................

  Quantity of CDs ...............................................
  CD Price (for Europeans: 500Bfr, else: 600 Bfr) ...............
 -----------------------------------------------------------------
  TOTAL COST (Price x Quantity) (*): ............................

  (*) If you are paying in another currency then Belgian Francs,
      then write down the conversion here.      

  * Payment by:

    [ ] Cash
    [ ] International Money Order
    [ ] Check (from Belgium only!)

  From where have you heard about audiophonik ? (optional)
  ...............................................................
 