RO0211

Last Name, First Name Street Signature Signature ZIP/City/County Fon, fax E-mail Fax: +4934148474-290 www.oemus.com OEMUS MEDIA AG Holbeinstraße 29, 04229 Leipzig, Germany Tel.: +4934148474-201, Fax: +49 34148474-290, E-Mail: grasse@oemus-media.de I would like to subscribe to Dentalzeitung (6 issues per year) for € 34 including shipping and VAT for German custo- mers, € 36 including shipping and VAT for customers outside Germany, unless a written cancellation is sent within 14 days of the receipt of the trial subscription. The subscription will be renewed automatically every year until a written cancellation is sent to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Notice of revocation: I am able to revoke the subscription within 14 days after my order by sending a written cancellation to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany. You can also subscribe via www.oemus.com/abo INNOVATION+INFORMATION roots 2/11 I would like to subscribe to ZWP (10 issues per year) for € 70 including shipping and VAT for German customers, € 72 including shipping and VAT for customers outside Ger- many, unless a written cancellation is sent within 14 days of the receipt of the trial subscription. The subscription will be renewed automatically every year until a written cancellation is sent to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date.