Louise et Joseph Simone Portraitistes

REGISTRATION FORM

PORTRAIT PHOTOGRAPHY WORSHOP
AT THE VINEYARD LA CÔTE DE VAUDREUIL FROM JUNE 4 TO 8 - 2012

DEPOSIT: $ 500.00 BEFORE MARCH 5, 2012
BALANCE : $ 1,000.00 BEFORE MAY 5, 2012
ALL LUCHES ARE INCLUDED
 NO REFOUND AFTER MAY 5, 2012
PRICE
$ 1,500.00
 PAS DE REMBOURSEMENT APRÈS LE 5 MAI, 2012
5% GST :
NAME :
8.5% TVQ:
ADRESS :
TOTAL :
    1 st DEPOSIT :
    2 nd DEPOSIT :
     PHONE :
    E-MAIL :
TOTAL :
PAYMENT METHOD (CIRCLE PLEASE) * CHECK * E-MAIL * VISA * MC * CALL IN * MAIL IN
CARD NUMBER : EXP. DATE :
OR CHECK PAYABLE TO SIMONE PORTRAIT    
NOTE: GST & TVQ FOR CANADIAN RESIDENT
GST FOR CANADIAN RESIDENT

Fill and Print this registration form and mail it at :
Louise et Joseph Simone, portraitistes
1370 de Calais,   Laval,   Québec, Canada,  H7G 4H5,

You can also reserve by phone : (450) 662-6980

 
simoneportrait@videotron.ca

Thank you,
LOUISE & JOSEPH SIMONE

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1370 de Calais,   Laval,   Québec, Canada,  H7G 4H5,      (450) 662-6980