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To place
your order, please print the following form,
complete it and
fax it to
us on:
+44 (0)15242
72219 or post it to the address at the bottom
of the page.
Alternatively,
go to our
secure
order page.
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Mr/Mrs/Miss/Ms:
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Address:
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Postcode:
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Daytime Tel No:
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DELIVERY ADDRESS (If Different)
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Mr/Mrs/Miss/Ms:
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Address:
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Postcode:
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Daytime Tel No:
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DESCRIPTION
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WEIGHT (kg)
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PRICE PER KG
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TOTAL
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DELIVERY DETAILS
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GOODS TOTAL
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CARRIAGE & PACKING*
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GRAND TOTAL
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*£10.50 up to 15kg +
£2 for every 5kg thereafter.
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Delivery to
the Highlands and Islands of Scotland is by
arrangement - Please enquire.
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METHOD OF PAYMENT
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Please debit my (please
circle):
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MasterCard
Visa Visa
Electron
Switch
Solo
Delta
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Credit Card No:
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Valid From
(mm/yy):
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Expiry
(mm/yy):
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Issue Number (Switch/Delta
only):
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Signature:
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Or, I enclose a cheque/postal
order for
£____________
Payable to 'Mansergh Hall'
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IF PAYING BY CREDIT CARD, CARD HOLDER'S NAME,
ADDRESS AND TELEPHONE NUMBER MUST BE SHOWN,
IF DIFFERENT FROM ABOVE
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Name:
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Address:
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Post Code:
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Daytime Tel No:
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