Ordine via Fax

ORDER FORM send to: Alcova srl - Fax +39 06 6864118

Fill out the form completely. If necessary use more than one page.

Pag. n. of

Dati Cliente (FILL ALL FIELDS)

Name

___________________________________

Surname/Company

________________________________________

VAT num..

_______________________________

Address

___________________________________________________________________________________________

Town/State/Country

_____________________________________________________________________

ZIP

_______

E-mail

___________________________________________

Phone

___________________

Fax

____________________

Indirizzo spedizione (Se differente da quello indicato sopra)

Name

___________________________________

Surname/Company

________________________________________

Address

___________________________________________________________________________________________

Town/State/Country

_____________________________________________________________________

ZIP

_______

CODE

PRODUCT NAME

OPTIONS (size, colour)

Q.TY

PRICE

TOTAL

________	___________________________	_____________________	____	_______	_______
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________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
________	___________________________	_____________________	____	_______	_______
Subtotal					€________
Shipping					€________
COD					€________
Totale					€_______

Tipo di pagamento:

COD (Add €6,00 to subtotal)

Credit Card:

VISA

MASTERCARD

AMERICAN EXPRESS

Name on card ____________________________________ Card number ____________________________

Expiration date: ___________________ (mm/yyyy( CCV: ___________________

Bank wire transfer:
                Account name : Alcova srl      -         Bank: Banca di Roma
                IBAN: IT 22 H 03002 05022 000400849669    - SWIFT:
                Motive: indicate surname/company name and date of the order

Shipping:

Shipping in Italy: via SDA courier (Add 9 € to subtotal, free if the subtotal is greater than €120,00 and the total weight of the package is below 3kg and the sum of the 3 dimensions is smaller than 80cm)

Shipping abroad: shipping costs will be comunicated as soon as possible when the order is received

Notes:

Date: ____ / ____ / _______

Signature: ___________________________________________

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