Order form |
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Please , copy
this order form and send by e-mail : alsican@online.fr |
Or print this order form and send it by
postal mail to: |
ALSICAN
241
boulevard du 8 mai 1945
59240
DUNKERQUE
FRANCE
Phone
. ++ 33 3 28 20 32 15 / e-mail: alsican@online.fr |
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Order
form
ALSICAN:
241 boulevard du 8 mai 1945 - 59240 DUNKERQUE
- FRANCE
Name: |
First name: |
Address: |
City: |
Postal code: |
Country: |
Phone .: |
E-mail: |
Title or number and year of the canvas:
2006-80 |
Amount:240 Euros |
Check O |
Credit Transfer O |
PAYPAL O
secure payment: use PAYPAL :
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Please ,
do not send your payment
before having received the confirmation of your order form (terms
of sale)
secure payment: use PAYPAL :
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