Order from:  Cuban Studies Institute

Name:_____________________________________________________________________
Address:___________________________________________________________________
City / State / Zip:____________________________________________________________
Phone:____________________________________________________________________
E-mail:__________________________________________________________

Quantity:
Cuba: From Columbus to Castro ______            Cuban Jazz ________    Montaner ___________


Method of Payment
 [ ] Check enclosed (payable to Cuban Studies Institute)
 [ ] Please place a one-time charge on the credit card listed for the amount of $______________

 [  ] MasterCard  [  ] Visa [  ] American Express [  ] Discover
 
Card Number:__________________________CVV Number___________ Exp. _______
Name as it appears on card: ______________________________________________
Signature: _______________________________________________Date: ____________

Phone:____________________________________________________________________
E-mail:__________________________________________________________

By Phone: 786-803-8007
By Fax: 786-803-8068
By Mail:  Cuban Studies Institute, 1500 S. Dixie Highway, Suite 200, Bank of America Building, Coral Gables, FL 33146


Thank you!