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PRINT AN ORDER FORM

AT THE SIGN OF THE DRAGON
St. Ninians, New Road, WIGTOWN, Scotland, DG8 9JL
Tel: 01988 403 446 Email: sales@atthesignofthedragon.co.uk
Web Page: www.atthesignofthedragon.co.ukThis is a printable order form. Select ‘print’ from your file menu.

ORDER FORM

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): ………………………………