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Audio&video

Please complete this form and fax it to : BOOM audio & video France - Fax +33 950 36 33 22
     For north America and Asia, please order through our distributors.

I wish to order : Quantity :

I add 20 euros/unit for shipment.    Delivery time : 10 days max after full payment.

Boom audio & video will send me the bank informations, then I will pay in advance by bank transfer against Proforma Invoice.

Name
Company
Complete address
Country
VAT N° (European companies only)
Phone
Fax
E-mail
Delivery address (if different)

date :                                             Signature :