Order form - Begali's Web site

Order form

PIETRO BEGALI OFF. MECC. VIA BADIA 22, - 25060 CELLATICA (BS) ITALY
TEL. +39 0 30 32 2203 FAX +39 0 30 31 4941 e-mail: begali@i2rtf.com --- bbegali@gmail.com

FOR BANK WIRE TRANSFER:

BANK: BCC di Brescia Agenzia di Bovezzo

IBAN: IT 54 Z 08692 54150 00 2000 205616_Pietro Begali_ SWIFT: CCRTI T2T H00

ORDER FORM

Customer's Name*

Billing Address*

Shipping Address*

E-mail*

Phone Number*

CARD*

VISA
AMERICAN EXPRESS
MASTERCARD
XPAY (3D secure Payment for Visa and Mastercard)

Digits N.

CCV

Exp. Date (mm/yyyy)

Card Owner's Name

BEGALI KEY MODEL*

OPTIONS

CALLSIGN Gravure

Pieces*

Date*

Privacy*

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