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First name and last name :
Adress :
Zip code and Town :
Country :
Phone :
E-mail :
   
Plaques with Number and design
Tick style and size of plaque :

RECTANGULAR
Size in cm ( W x H )
Price
15 x 10
40 €
17 x 11
45 €
20 x 15
50 €

"NAPOLEON" SHAPE
Size in cm ( W x H )
Price
15 x 12
40 €
17 x 13
45 €
20 x 15
50 €

CUT OUT
flowers, cats, birds, etc
Size in cm ( W x H )
(may vary according to the shape)
Price
15 x 13 min.
50 €
10 x 18 min.
50 €
 

Plaques with Names and design
Tick style and size of plaque :

RECTANGULAR
Size in cm ( W x H )
Price
15 x 10
80 €
20 x 15
105 €
25 x 18
125 €
30 x 20
150 €
35 x 25
205 €
40 x 30
250 €
10 x 40
90 €
15 x 40
105 €

"NAPOLEON" SHAPE
Size in cm ( W x H )
Price
15 x 10
80 €
20 x 15
105 €
25 x 18
125 €
30 x 20
150 €
35 x 25
205 €
40 x 30
250 €
Your design

• 1 / Enclose image (picture, postcard, drawing, etc...) to reproduce or state the theme of your design :
• 2 / Text to be added (forename, surname, house name, number, etc...) :
• 3 / Holes for screws required :
YES NO

NB : colour and size may vary slightly according the firings

Shipping

Package and carriage costs : France 10 € - Europe 15 €
respectively 20 € and 30 € for the sizes marked in red coulour
Quotation on request for countries outside Europe
I have enclosed a cheque payable to "Poterie Tournesol"

If you require delivery before a certain date, please state here :

You can either complete this order form on-line (settlement by cheque on reception of the plaque) or print it and send it by post with the cheque to the name of "Poterie Tournesol" at the following address :
POTERIE TOURNESOL
7 Grand'Rue
06140 Tourrettes sur Loup
France