To pay by cheque print and complete the order form below and post to: Reggie's Den, PO Box 18, Midhurst, West Sussex, GU29 9LD. You can also use this form to pay by credit card and fax to 01730 815422

Customer Name
Customer Address

Post Code
Day time telephone number

Order Code	Quantity needed	Order Description	Price of Item

Postage Rates based on order value*
£0.00 - £9.99 = £4.00 postage
£10.00 - £24.99 = £5.00 postage	Total cost of ordered items	£
£25.00 - £74.99 = £6.00 postage	Plus Postage	£
£75.00 - £149.99 = £7.00	TOTAL TO PAY	£
£150.00+ = £8.00

Cheques payable to "Reggies Den" Or to pay by Credit Card complete the following

Card Holders full name

Sec Code

Card Number

Exp Date:

Address if different from above including house number and post code

Valid Date:

Issue No:

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