to order from our fifties and sixties

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Mr/Mrs

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To order from the fifties and sixties

Fill in the desired article from our fifties and sixties

Payment information

Please add the following P and P costs (registered mail) to total: Netherlands Eur 8,50, Europe Eur 15,-, outside Europe Eur 27,50.

Shipment information

Name *

Address *

ZIP *

City *

Country

Payment information

	by transfer to Rabo bank account: 10.65.65.672
	payable to J.C. Creations. IBAN: NL56 RABO 0106 5656 72. BIC: RABONL2U

	by transfer to ING bank account 73.69.380
	payable to J.C. Creations. IBAN: NL82 INGB 0007 3693 80. BIC: INGBNL2A

	creditcard
	We accept VISA and Mastercard

Creditcard information

VISA or Mastercard

Name as mentioned on the card

Number

CVC Code

Expiry date

You can send this form by clicking on the button "Send". Or you can print the form and send it to us by post.

Our address: J.C. Creations, Baron G.A. Tindalstraat 150, 1019 TX Amsterdam. The Netherlands.