Order Form

Survey : World passive and interconnection component markets database (2009-2014)

To order, print, fill out and return this order form to DECISION

By fax
+ 33 (0)1 45 05 72 65

By mail
DECISION
Espace Hamelin
17 rue de l'Amiral Hamelin
75116 Paris
France

Your order

Please indicate your choice : 

• Zone choice: 
  - one region:Europe, North America, Japan, China, Other Asia Pacific, Rest of the World
  - or total world with regional data ?
  _______________
  
  
• Component choice: 
  • One or several component group(s)?
    _______________  _______________  _______________
    _______________  _______________  _______________

PRICE
- option(s) selected: ___________________ euros

Note : for delivery in France only the 19,6% VAT will be charged additionally. Please check and pay the total amount  (PRICE + VAT) :
price ___________ + VAT (19,6%) ____________ = _____________ euros

Name:
Organisation:
Position:

Address:
Town:
Zip Code:
Country:

Phone:
Fax:
e-mail:

VAT number :
Signature

Payment details

__ I enclose a cheque payable to DECISION
__ I PAY By bank transfert to

DECISION 
Bank : BNP Kleber, 51 avenue Kleber, 75116 Paris, France
Account number: 00021268136 21
IBAN: FR7630004008920002126813621

© DECISION - 2010