SECURE SERVER-MODE

LA PIAZZA exclusive Shoefashion      ORDER-FORM

We will confirm your order asap.

*** YOUR  ADDRESS ***
Customer-No:  (for Firstorder "NEW")
Firstname:
Familiy-Name:
Street:
ZIP:
City and State:
Country:    Please select
Telephon:
EMail: (important) Really sure ??
Birthday:
Notes:

                                     *** DELIVERY AND PAYMENT-METHOD ***

You can return unworn  shoes  within 14 Days ! ( No Special Design´s )
 

Payment and delivery   (No COD)  :

Moneyransfer with post :
at Western Union money transfer services

Banktransfer :
Raiffeisenbank  (Germany) 40789 Monheim BLZ: 370 695 21 Account: 10 24 11 021 IBAN DE24 3706 9521 0102 4110 21 BIC CODE GENODED1 MNH
Stadtsparkasse (Germany) 40723 Hilden     BLZ: 334 500 00 Account: 34 365 155

Your Creditcard :  Card-No.      :  Expire-Date  : 
Creditcard Verification Value  (3 digits on the back) : 
 
 

  *** YOUR ORDER ***

Heels - with 4 inch = 10 cm (size 38/ 5 UK / 7 US ) or 5,5  (size 38/ 5 UK / 7 US ) to 6 inch = 16 cm  (size 43/ 9 UK / 12 US )

Please click the box for the article:
If you want to order more articles please use the backwards key and add the next 3 items:
Art-No  Description  Size Colour Material Heel Price


Total
Fright, package and insurance
Grand Total