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<TITLE>how to order lasers, laser crystals, Nd:YAG, Nd:YVO4, Yb:YAG, Nd:YLF, Cr:Ruby, Ti:Sapphire, Nd:YAP, KTP, BBO, CLBO, KNbO3, Ni:KNbO3, KDP, DKDP, LiNbO3, Fe:LiNbO3, Mg:LiNbO3, Nd:Mg:LiNbO3, Cr:LiNbO3, LiTaO3,BaTiO3, Rh:BaTiO3</TITLE>
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<META NAME="Author" CONTENT="ROITHNER LASERTECHNIK, Andreas Roithner">
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<div id="breadcrump"><a href="index.htm">Home</a> / Order</div>
<h1>Request an order or offer</h1>
<p>If you need some more details or you need advice, please fill out the form below or call our <a href="contact">technical sales assistants</a>.</p>
<p>You already know what you need? Please fill out this form also, but tell us your payment details and the required adress. We do not accept orders by phone!</p>
<p class="abstandvor imp"><b>* These are the most important information to handle your request! </b></p>
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Company *</td>
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No *</td>
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<h4><label for="fax">Fax Number:</label></h4>
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<td><h4 class="imp"><label for="name">Contact person (name, surname): *</label></h4>
<p><input class="feld" id="name" type="text" name="name" size="50" maxlength="150" /></p>
<h4 class="imp"><label for="mail">E-mail: *</label></h4>
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<tr><td><h4>Billing address:</h4>
<p><input class="feld" type="text" name="bill_street" size="50" maxlength="150" value="street name & number" /></p>
<p><input class="feld" type="text" name="bill_add" size="50" maxlength="150" value="" /></p>
<p><input class="feld" type="text" name="bill_city" size="50" maxlength="150" value="city" /></p>
<p><input class="feld" type="text" name="bill_country" size="50" maxlength="150" value="country" /></p>
<p><input class="feld" type="text" name="bill_zip" size="50" maxlength="150" value="zip" /></p>
<h4 class="imp">VAT only for European Customer:*</h4>
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<td><h4>Shipping address: <small>(If it is different to the billing adress.) </small></h4>
<p><input class="feld" type="text" name="ship_street" size="50" maxlength="150" value="street name & number" /></p>
<p><input class="feld" type="text" name="ship_add" size="50" maxlength="150" value="" /></p>
<p><input class="feld" type="text" name="ship_city" size="50" maxlength="150" value="city" /></p>
<p><input class="feld" type="text" name="ship_country" size="50" maxlength="150" value="country" /></p>
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<h3 class="abstandvor">Your preferred payment method</h3>
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<input type="radio"class="checkbox" name="pay" value="advanced"/>in Advance by banktransfer
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<p class="abstandvor">For payment by credit card please send us the following information <b>by fax (0043 586 52 43 44)</b> <br> or by e-mail <a href="mailto:office@roithner-laser.com">office@roithner-laser.com</a>:</p>
<p>Cardnumber, name of cardholder, expirationdate, security code (from the backside of your card)</p>
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<p>We do accept orders on our terms and conditions only</p>
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