Order Form

Please fill in all details...then print out using browser print button...and send with payment to: Ginger Tom, 12 The Maples, Carterton, Oxfordshire, OX18 3HB

Name

Address

Town / County Post Code

Telephone No. / E-mail

QTY. Code Description Price

QTY. Code Description Price

QTY. Code Description Price

QTY. Code Description Price

QTY. Code Description Price

Please add postage and packing (up to 5 kits) Total

METHOD OF PAYMENT (after printing this page, please complete the following)

I enclose a cheque or postal order made payable to Ginger Tom [ ]

Please charge my credit/debit card [ ] indicate card type: Visa [ ] Mastercard [ ] Delta [ ] Switch [ ]

card number ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... expiry date ... ... ... ...

(Switch issue number ... ... / start date ... ... ... ... ) name on card.................................

cardholders signature....................................................

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