FORMULAIRE
D'INSCRIPTION
Votre nom
Your first name :
Votre prénom
Your last name:
Votre e-mail:
Your e-mail:
Votre numero de téléphone:
Your phone number:
Lieu de residence:
Country:
Afghanistan
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China (Hong Kong S.A.R.)
China (Macau S.A.R.)
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, Democractic Republic
of the
Cook Islands
Costa Rica
Cote D'Ivoire (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
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Egypt
El Salvador
Equatorial Guinea
Eritrea
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Ethiopia
Falkland Islands (Islas
Malvinas)
Faroe Islands
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Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia, The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
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Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
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Kenya
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Korea
Korea, North
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia, Former Yugoslav
Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
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Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
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Nauru
Nepal
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Netherlands, The
New Caledonia
New Zealand
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Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
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Paraguay
Peru
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Pitcairn Island
Poland
Portugal
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Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent And The Grenadines
Samoa
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Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South
Sandwich Islands
Spain
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Sudan
Suriname
Svalbard And Jan Mayen
Islands
Swaziland
Sweden
Switzerland
Syria
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Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
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Uganda
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United Kingdom
United States
United States Minor Outlying
Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy
See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
FORMULAIRE
DE LIVRAISON
A qui l'oeuvre doit-elle-être
livrée ?
To whom the painting
should be delivered:
Adresse de livraison:
The address for the delivery:
Ville de livraison:
The city for the delivery:
Zip Code de la livraison:
The zip code for the delivery:
The state for the delivery:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
in United States
Pays de livraison:
The country for the delivery:
Afghanistan
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
China (Hong Kong S.A.R.)
China (Macau S.A.R.)
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, Democractic Republic
of the
Cook Islands
Costa Rica
Cote D'Ivoire (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Islas
Malvinas)
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia, The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Korea, North
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia, Former Yugoslav
Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands, The
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua new Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South
Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard And Jan Mayen
Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying
Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy
See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Tableau que vous voulez
acheter:
The painting you want to buy:
Choix du tableau
CSL 100 : l'heure du thé : 4 850 FF
CSL 101 : Les citrons verts : 4 830
FF
CSL 304 : Vase Bleu au miroir : 11
500 FF
CSL 309 : Roses et oranges : 11 500
FF
CSL 328 : Les tulipes de Lanï : 22
500 FF
CSL 330 : Vue de Lanaî : VENDU
CSL 338 : Lavendes : 32 000 FF
CSL 340 : Provence et cartes postales
: 28 750 FF
CSL 342 : Nageurs : 26 000 FF
CSL 343 : Les meilleurs sont gardés
: VENDU
CSL 348 : Cerises et Paysage de Nouvel
Angleterre : 19 400 FF
CSL 349 : Nishikigoï : 29 000 FF
CSL 357 : Miroir et Hydrangas coupés
: 28 900 FF
GVB 1 : Pot de fleurs (bis) : 5 200
FF
GVB 2 : Corbeille de cerises : 5 200
FF
GVB 3 : Pots de fleurs : 5 200 FF
GVB 4 : Jeune fille nue : 9 100 FF
GVB 5 : Femme devant miroir : 18 850
FF
GVB 6 : Corbeille de fruits : 24 000
FF
GVB 7 : Conte de fée : 21 450 FF
GVB 8 : Femmes : 25 350 FF
GVB 9 : La rousse : 7 150 FF
GVB 10 : Colombes : 7 150 FF
Sculpture que vous voulez
acheter:
The sculpture you want to buy:
Choix de la sculpture
ADF 1 : Autruche bleue : 8 640 FF
ADF 2 : La barque : 1950 FF
ADF 3 : La voile : 10 000 FF
ADF 4 : Personnage sur un animal imaginaire
: 4 000 FF
ADF 5 : Femme enceinte : 8 750 FF
ADF 6 : Le coq : 12 650 FF
ADF 7 : La tour : 6 400 FF
ADF 8 : Oiseau tête levée : 7 450
FF
ADF 9 : Le grand héron : 8 750 FF
ADF 10 : L'elan : 8 750 FF
ADF 11 : Femme à la tête levée : 6
100 FF
ADF 12 : Femme à la main levée : 8
650 FF
ADF 13 : Figure debout : 8 650 FF
ADF 14 : Barque au personnage : 2
900 FF