Manual order form
No data is transferred through the computer network
1/ Print
2/ Fill in
3/ Send payment to :
Service Nouvelles Technologies
INSTITUT LUMIÈRE
25 rue du Premier-Film
BP 8051
69352 - Lyon Cedex 08
Tél. 33 04 78 78 18 95
Fax 33 04 78 01 36 62
contact@institut-lumiere.org
Date
Mr Mrs
Name
Forename
Position
Corporate name
Street
Zip code & Town
Country
Telephone number
Fax number
E-Mail
Payment to be invoiced
By French check
By credit card

Credit card No.
Expires end of
Holder’s name
Holder’s given name
Ref.
Description
Qty
Unit
Price
Total
Price
4 euros Mailing charge except subscriptions
Mailing charge
Total
Signature required
In accordance with the French "informatique et libertés" (information technology and personal liberties) law of January 6th 1978, you retain the right to access, correct and delete all personal information concerning you. Contact the above address if you wish to exercise this right.