Booking Form

Surname:.......................................First Name:................................................

Address:.........................................................................................................

Post code :....................................................Town:.........................................

Tel:............................................e-Mail:..........................................................

 

Please enclose a cheque for 80 € made out to Janet Cintas, to print one colour, edition of six prints.

Date:........................................................Signature.........................................

 

Please return this form by post to:

Janet Cintas
Ligneras 24360 Saint Estephe,FRANCE