Formulaire de réservation
Transcription
Formulaire de réservation
Mondial de la Bière, 2236, rue Beaubien Est, Montréal, (Québec) Canada H2G 1M7 • Téléphone : 514-722-9640 • Télécopieur : 514-722-8467 • Courriel : [email protected] Formulaire de réservation Mondial de la Bière Take advantage of our special offer! T h e B e e r T re k Ma p s PRICE p e r PA CKA G E Q u a n tity PACKAGE DEAL DISCOVERY(1) $ 3 5 . 0 0 x = $ $ 1 0 . 0 0 x = $ $4.00 x = $ $4.00 x = $ $ 4 .0 0 x = $ $ 4 .0 0 x = $ $ 4 .0 0 x = $ $2.95 x = $ $2.95 x = $ $2.95 x = $ $2.95 x = $ R m ake your choice am ong our products by ITEM (1) : O PRICE p e r IT E M Q u a n tity Québec (B ilin g u a l) 2 0 1 6 , 1 3 th e d itio n California $35 (E n g lis h ) 2 0 0 6 Colorado Taxes included (E n g lis h ) 2 0 0 6 Delaware, New Jersey, New York 10 Beer Trek Maps Includes (E n g lis h ) 2 0 0 6 Illinois, Michigan, Wisconsin (E n g lis h ) 2 0 0 6 9 US and Canadian maps in English Manitoba, Ontario, Saskatchewan and (E n g lis h ) 2 0 0 5 (E n g lis h ) 2 0 0 6 N ew England Penns y lv ania 1 Québec map 13 th edition 2016 bilingual (E n g lis h ) 2 0 0 5 Oregon (E n g lis h ) 2 0 0 5 Alas ka & W as hington (E n g lis h ) 2 0 0 5 A value of $41.80 Save $6.80 Sub-total: (A ll p r ic e s in c lu d e ta x e s ) Handling and s hipping fees : Total order: fax to: Mondial de la Bière: 514-722-8467 I, THE UNDERSIGNED, AUTHORIZE THE MONDIAL DE LA BIÈRE TO DEBIT MY CREDIT CARD: VISA MASTER CARD + $ (T o b e c o n fir m e d d e p e n d in g o n q u a n tity ) Fill in the following form and $ AMERICAN EXPRESS CARD NUMBER: CARD NUMBER: EXPIRATION DATE: NAME (PLEASE PRINT): SIGNATURE: DATE: ESTABLISHMENT: $ Payment: Check Box By cheque (Make to the order of Mondial de la bière) Please send your cheque and payment authorization form by mail to: Mondial de la Bière, 2236, Beaubien Street East, Montréal (Quebec) Canada H2G 1M7 ADDRESS: CITY: Check Box COUNTRY: By credit card POSTAL CODE/ZIP CODE: TEL.: IMPORTANT: Your confirmation will be received by fax or email. Fax: Email: (1) • Purchases/reservations are non-refundable • Offer valid until stock depletion. Please add 3% if you pay with a credit card, thank you!