Internet Hoc Mon, Vietnam: information request form (E)

1) fill the present form
2) confirm it
3) enter credit card details on secured server

We
accept

Name :

Email :
(orders from generic Email such as *@hotmail.com or *@usa.net, etc... refused)

Address :

Oversea subscription :

21 USD for 30 Emails exchanged to and from Vietnam

How did you come upon this site ? (optional)

	Just browsing
	Word of mouth
	Search engine (Please specify)
	Newsgroup (Please specify)
	Another page (Please specify)

note: the bill will be under the name of "consultec Co., Ltd."

Webpage HTML 4.0 compatible/ last updated 22.05.2002