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Photolithography Order Form

Art Work:

Preparation

Taxes are included.

Personal Information:

Mr.Mrs.

Surname:
Given Name:
Address:
City:
Province or State:
Country:
Postal/Zip Code :
Home Phone Number:
Work Phone Number:
Fax Number:
Email Address:

How did you eard about this lithography ?

Comments:

Visa payment:

For security reasons, if you wish to pay with Visa, please contact us.

Payment by cheque:

To complete your registration, please mail your cheque to the following address:

6, Saint-Jean-Baptiste St., Suite 102, 2nd Floor, Baie-Saint-Paul, QC G3Z 1L7
The payment by cheque must be made to the order of COFEC - Rêves d'automne.

For Information:

Email Address:
By fax: (418) 435-0126
By telephone: : (418) 435-5875 ou 1-800-761-5150