ORDER FORM

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Order Form 

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  Fill out the order form :

To place an order, fill out carefully the order form below. Don't forget to mention :
• Your name and address (the fields followed by * are required).
• Your order : precise clearly the title, the reference (ex : BN2140) and the quantity.
• The method of payment : one of the two methods below.
• You will receive an estimate by e-mail and upon receipt of your payment, the works ordered will be sent to your postal address.

  

 

 Name and Address

Title  

Mr     Mrs    Miss 

 NAME *  

First Name * 

Society or activity  

VAT (if any)  

Phone  

Fax  

 E-Mail *  

 Address *  

Post code *  

       City *  

Country *   

 

 Order

 Title  
Reference
Quantity
# 1
# 2
# 3
# 4
# 5
# 6
# 7
# 8
# 9

 Method of payment

Bank money transfer (our account number will be sent by mail) 

Paypal (you'll receive an email from Paypal)

GENTLE SOURCE
BAYARD-NIZET Music Publishing
Rue des Ecoles, 6
4970 - STAVELOT (Belgium)
Tel & Fax +32 (0) 86 24 37

  


 

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