Terres Est-Ouest
RESERVATION FORM

Terres Est-Ouest
Le Manoir / 89560 Lain, France
Tel : 03.86452774 ; Fax : 0386452708
Email : teo@france89.com
To be printed (please send it by mail, fax ou email)

Name(s) _______________________________________________
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Address _______________________________________________
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________________________________Postal code _____________
City ___________________________ Country ________________
Tel/fax/e-mail ___________________________________________
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Course(s) choice_________________________________________
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from__________________________ to_______________________
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Arriving date _______________ departing date_________________
Accommodation choice : T.E.O. �____________________________
(at) Bed & Breakfast �_____________________________________
Camping �_____________________________________________
Without accommodation �_________________________________
Observations____________________________________________
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Ceramic experience_______________________________________
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Fees : stage (fee)_________________________________________
Accommodation (fee)_____________________________________
Way of payment Chèque �; Espèces �; Autre__________________
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__________________________ Date________________________
I wish to book for the above pottery course,
enclosed is _______________ euros. (we sugest, 20% of the fee).
Signature





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Observations :