Musée des Acadiens des Pubnicos - BOUTIQUE

Société historique acadienne
de Pubnico-Ouest

C.P. 92
Pubnico-Ouest
Comté Yarmouth, N.-É.
B0W 3S0
902-762-3380 (Tel)
902-762-0726 (Fax)
Date:
Address:
City:
Province/State:
Code:
Telephone

Item / Description Quantity Unit Price Sub-total Postage Total
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
x $ = $ + $ = $
Total $

Please print, fill-out and return form to the Musée des Acadiens des Pubnicos et Centre de recherche with a cheque or money order for the correct amount

(Made payable to the Société historique acadienne de Pubnico-Ouest)
(U.S. residents please send Canadian funds)