Espace Plaisirs

ORDER FORM
invoice substitute

Send to :
Espace Plaisirs SARL
Quartier Sérignan - 26700 Pierrelatte
FRANCE

First name :

Name :

Company :

Address :

Zip Code :

City :

Country :

Phone :

Fax :

E-mail :

Description	Our Price	Quantity	Total
P&P : 3 by item
GRAND TOTAL

Prices include all taxes
(VAT : 19,6% for CD and P&P)

Please send your check payable to Espace Plaisirs

Date ...................................
(Signature)