GIFT OPTION FORM

I'd like to give a year of Lingua Franca (9 issues) as a gift to:

Name:
Address1:
Address2:
City:
State:		Zip Code:
Country:
Telephone:
E-mail:

Gift from:

Name:
Address1:
Address2:
City:
State:		Zip Code:
Country:
Telephone:
E-mail:
Bill me. I will pay later. Charge my credit card. (MasterCard, Visa, American Express)
Card Holder Name:
Card Number:	Exp:
Foreign Postage: Add $11 surface mail, $21 airmail. US funds (on a US bank) only. Please allow 6 weeks for delivery of first issue.
If you are not comfortable about sending your information over the net, please print out this form and fax it to: 212-302-0847 (USA).