Your Gourmet
Provence Experience
Reservation
Form
~
please print out and fill out this form in order to send it to us via
mail, e-mail or fax ~
Name:
_________________________________________________________
Address: _______________________________________________________
_______________________________________________________________
City: ___________________________________________________________
Prov. or State: ___________________________________________________
Postal or Zip Code: _____________ Country:
________________________
Tel: (office) ___________________ (home)
___________________________
Allergies: _______________________________________________________
How did you hear of us? __________________________________________
_______________________________________________________________
Book now as space is limited for July 24 -31, 2010!!
Enclosed is my deposit for CDN$500
Please make cheques payable to:
Your Gourmet Provence Experience
#605-1438 Richards Street
Vancouver, BC V6Z 3B8
Canada
Fax: 604-899-8027
If you wish to use a credit card we
have a Pay Pal account and can send you a request by e-mail for the
payment. Please e-mail vivaci@telus.net
to use this service.
or right-click here to download this
form in Microsoft Word format; fill it out and send as an e-mail
attachment to:
info@gourmet-provence-et-vous.com