To order, print out this form, enter details of the kits and charts that you want and send with your remittance to:
| ORDERED BY | |
| Title: Mr / Mrs / Miss / Ms Initials: _______ | Date: _________ |
| Lastname: | _______________________ |
| Address: | _________________________________________________________________ |
| _________________________________________________________________ |
| _________________________________________________________________ |
| _________________________________________________________________ |
| _________________________________________________________________ |
| _________________________________________________________________ |
| Postcode | _______________________ |
| Telephone: | ________________________________ |
| E-mail address: | _________________________________________________________________ |
| Card No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ |
| Expiry date __ __ / __ __ |
Cardholders signature ______________________________________
|
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| [ ] Tick if you would like us to confirm your order by e-mail (don't forget to fill in your e-mail address above) |
[ ] Tick if you would like to go on our mailing list.
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| Send the completed form and your remittance to County Needlecraft Ltd, Glendale, Park Lane, Carhampton, Minehead, Somerset TA24 6NL, United Kingdom Telephone +44 (0)1643 821850 |