Order - By FAX or
Post
0044 (0)1354 610393
|
Please print this page and include the
following information so your
credit/debit
card can be charged.
Our VAT No: 794 8317 79
|
Quantity
|
Product
description
|
Amount
(all incl.of
VAT @ 17.5%)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Postage for
UK
|
ฃ 4.00
|
|
Total
|
|
Total to be charged: ฃ
______________________
Name
.....................................
....... (exactly as it appears on card) Please
print name in black
Card Number
.............................
.................
CREDIT | DEBIT (delete not applicable)
Issue Date
...................................
Exp Date
.....................................
Verification Number
..................... Issue no (Switch
only) ..................
Card Holders Address
.....................................................................................................
......................................................................................................................................
County
.....................................................
...
Post Code
...............................
Telephone number in case of problems
please
...................................................................
Delivery address if different
....................................................................................................
......................................................................................
Post Code
..............................
Is this a gift? (y/n) Do you want the
receipt sent to the card holders
address? (y/n)
Please sign to confirm your
instructions for us to charge the
above card
Signed
...
|
Post
to:- Linda Briggs, Phoenix House, Main Street,
Welney, Norfolk, PE14 9RB
|
