Name * Street Address * City * State * Country * Zip Code * Daytime Phone * Facsimile E-Mail Address * Book Name The Cuisine of Cambodia Quantity Mailing Preference * Airmail Airmail Express Surface Mail Courier Payment * VISA MasterCard Wire Transfer to Bangkok Bank, Sunthorn Kosa Road Branch, Acc. No. 218-0- 339240, Nusara & Friends Co., Ltd. Please fax the transfer receipt to 0 2578 0428 Card Number * Expiry Date * Name as on Card *