ORDER FORM (regular mail)

NAME and first name:
Complete address and postal code:
 
Telephone : E-mail :
I wish to order:
Quantity Title
Unit price
Total price
       
       
       
       
       
       
 Shipping charges (no charge for orders over 50 euros)
 10 euros
 Total :  
I am sending, to the order of the
Amis du Centre du XXe Siècle
CCP Marseille 5 375 36 T
RIP : Établissement 20041
 Counter 01008
 Account N° 0537536T029
 Clé 86
by chèque / CCP / money order 

the sum of: .............................................................
(Contact us for special orders - institutions, booksellers...)
Please print this page and send it, with payment,
to the following address:
DADART - CENTRE DU XXe SIECLE - 81, rue de France - 06000 NICE - France
Are you looking for a particular Dada document?
If so, which one? ...........................................
Would you like to receive an offer? Yes/No
Do you possess a Dada document that you would like to sell?
If so, which one? ...........................................
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