ALEX W DALGLEISH

Tel: 01355 303595

ORDER FORM

At the moment we do not have a secure socket so this Order Form can be completed with your credit card details, printed out faxed or mailed with a cheque.
International orders can be faxed to 01355 303595.
Telephone orders welcome: 01355 303595 (International: +44 1355 303595)

Please specify the goods you require :

Qty.	Description	Code	Size/Colour/etc.	Price

Post and Packing will be added at cost. Prices on this web site include VAT at 17.5%
Customers in countries out with the EC will not be charged VAT.

Please provide the following details:

Name		Card Type: Visa MasterCard American Ex Switch Delta
Address
Town
County or State
Postcode or Zip
E-mail
Phone
Fax
Credit Card Number:
Card Issue No:
Card Start Date:
Card Expiry Date:

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