Order form

 

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

 

 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:
Amount:
Check O only accepted in France and Belgium
Credit Transfer O

PAYPAL O

secure payment: use PAYPAL :







 

 

 

Please , do not send your payment before having received the confirmation of your order form (terms of sale)

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