Wessex House, Oxford Road, Newbury, Berkshire RG14 1PA - England

E-mail: info@lavaironniere.co.uk - - Fax: +44 (0) 1488 68 43 83

- REQUEST FORM FOR DETAILLED INFORMATION CONCERNING A SPECIFIC PIECE OF WORK -

For £20.00, $ 32.00 or € 38.00 we can send to you all detailled information concerning a specific piece of work. In case of purchase, you will deduct this amount from the total price of this piece of art. You will receive a detailled description of the work and a minimum of three photos, one showing the piece in entirety, and two showing its most interesting details.

PLEASE SEND ME MORE INFORMATION CONCERNING :

WORK NUMBER : - - TITLE :

- ABOUT YOU -

Title: Ms - Mr

Surname :

First Name :

Street :

Number :

Town / City :

ZIP / Post code :

County / Province :

Country :

Telephone :

Fax :

E-mail :

  - METHOD OF PAYMENT -

CHEQUE ENCLOSED OF: £20.00 - $32.00 - €38.00 ( Please cheque payable to LA VAIRONNIERE GALLERY. Please write your full name and address on the back of the cheque )

PLEASE DEBIT MY :

- - - - - CARD EXPIRY DATE: (Month & Year)

CARD NUMBER:

SIGNATURE :

IF YOU WANT TO CONTACT US :

CLICK HERE TO : - CLICK HERE TO :

- HOME PAGE - - MONET ROOM - - RODIN ROOM - - TURNER ROOM - - ORDER FORM -