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NAME: …………………………………………………………………………………
ADDRESS: …………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………
TELEPHONE: Home: ………………………………………… Work: …………………………………………
EMAIL ADDRESS (if any): …………………………………………………………………………………………
WOULD YOU LIKE TO GET FUTURE CATALOGUES BY EMAIL? Yes/No
Payment Options (please delete what does not apply) –
A) I have an account with you in credit.
B) I enclose cash/postal order/cheque No. ………………… /Book Token for the sum of £ ……………
please:
i) refund any unused balance
ii) credit unused balance to my account
C) I should like to pay by credit card – details as listed below :-
Type: ………………… Name on card: ………………………………………………………………
Number: ……………………………………………… Starting date: …………………………………
Expiry date: ………………………………………… Issue No. (if any): ……………………………
Security No. (on back by signature): …………………………
Catalogue: ………………………………………………………… A/C No. (if known): ………………………………
| Catalogue Ref. | Title and Author | Price |
|---|---|---|