Order form for private individuals from the EU and Switzerland

ORDER FORM
(Reserved to individuals from the European Union – Valid until 1st January 2016)

Please print this order form, then fill in your order and details and POST with your payment to:

MAPPEVERBE SARL
6 CITE DES SAPINS
25450 DAMPRICHARD

FRANCE

	Ms Mrs Miss Mr Dr Prof (please tick or specify other): .............................
Surname:	........................................................................................................................................
First Name :	........................................................................................................................................
Address :	........................................................................................................................................
	........................................................................................................................................
Postal code:	......................................Town : .......................................................................................
Country:	................................................................................................................................................

Thank you for writing your phone and email below to help us better serve you (* optionnal) :

Phone*:	........................................................................................................................................
Email* :	........................................................................@............................................................

According to French data protection laws, you may access or modify any data that is being held about you.

Ref.	Titles		Unit Price (VAT incl.)	Quantity		Total Price (VAT incl.)
CPG1	La conjugaison à pas de géant	€	8,90		€	_ _ _ , _ _
CM-1	La carte mémoire des terminaisons des 7 temps principaux	€	0.24		€	_ _ _ , _ _
CM-2	La carte mémoire des terminaisons de l'indicatif présent	€	0,29		€	_ _ _ , _ _
M90	Mappeverbe de conjugaison française en 90 verbes * out of print *	€			€	_ _ _ , _ _
C90	Mappeverbe au coeur de la conjugaison française	€	4,95		€	_ _ _ , _ _
F90	Mappeverbe fast track to French verb forms in 90 verbs	€	5,50		€	_ _ _ , _ _
PZIP6	Puzzles de conjugaison de l'indicatif présent (6x 2 pièces)	€	2,25		€	_ _ _ , _ _
R222-1	La règle à conjuguer 222 verbes * out of print *
	Subtotal				€	_ _ _ , _ _
	Don't include "La carte des terminaisons CM-1 & CM-2"			=
	Postage & packing (incl. VAT) per item (except CM-1 & CM-2) Zone* outside the EU	€	1.00		€	_ _ _ , _ _
	Postage & packing (VAT Incl.) per order	€	6.00	1	€	6 , 0 0

I accept the terms and conditions of sales.
Mappeverbe may wish to send you information in the future by post or email on other products or services. If you do not wish to be included on our mailing lists, please tick here

.

Signature: Date: _ _ / _ _ / 2015.

Payment: I enclose my cheque for € ....................... made payable to MAPPEVERBE SARL (cheque must be drawn against a bank in France) or proof of bank transfer made payable to MAPPEVERBE SARL (with no banking fees charged to us) to our Crédit Agricole bank account :

IBAN : FR76 1250 6200 0355 0163 7172 144 AGRIFRPP825.

MAPPEVERBE
6 cité des sapins - 25450 DAMPRICHARD – France
SARL au capital de 444 Euros – APE : 5811 Z - RCS Montbéliard 478 367 998

N° de TVA Intracommunautaire : FR-64-478-367-998
Site Internet : www.mappeverbe.com- Email :

Countries of the EU zone : Germany, Austria, Belgium, Bulgaria, Cyprus, Denmark, Spain, Estonia, Finland, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Liechtenstein, Luxembourg, Malta, Netherlands, Poland, Portugal, Czech Republic, Rumania, the United Kingdom, Slovakia, Slovenia, San Marino, Sweden, Vatican.

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