Page/Title: ____________________________________________________________________________
Français/French ou/or Anglais/English
Fille/Girl ou/or Garçon/Boy
Prénom/First Name: _____________________________________________________________________
2ième Prénom/Middle Name (optionnel/optional): _________________________________________
Nom de Famille/Last Name: ______________________________________________________________
Âge/Age (optionnel/optional): __________________________________________________________
Ville/Hometown: ________________________________________________________________________
Province/Province: _____________________________________________________________________
2-4 Amis ou Parents/2-4 Friends or Relatives: __________________________________________
1) _____________________________________________________________________________________
2) _____________________________________________________________________________________
3) _____________________________________________________________________________________
4) _____________________________________________________________________________________
Message/Message: (2-3 lignes/2-3 lines):
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
ADRESSE D’EXPÉDITION / SHIPPING ADDRESS:
Nom/Name: ______________________________________________________________________________
Adresse/Address: _______________________________________________________________________
Ville/City: ____________________________________________________________________________
Code Postal/Postal Code:________________________________________________________________
Téléphone/Telephone: ___________________________________________________________________
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