طًمٍ$يوى Publishing Order Form
________________________________________________________

Instructions

Please print out the form below, fill in your order, and mail with payment to:

Dayen/Chlen$kiy Publishing
48 east 66th street, suite 1R
NYC 10021 USA

Shipping/Handling

U.S. and Canada: $2 for each item.
Elsewhere: For information please email us at editor@chlenskiy.com

Items are usually shipped via book rate within 5 business days.
Please make checks payable to Dayen.

Name: _________________________________
Address 1: _________________________________
Address 2: _________________________________
City, State, Zip: _________________________________
Email: _________________________________

  Order:

Quantity Book/Magazine Title Price
     
     
     
     
 
Shipping/Handling:
$
 
Total:
$

If you have any questions, please email us at editor@chlenskiy.com
Thank you for your order!