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 |
ORDER No:
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| Customer Name | |||||||
| Customer Address
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| Post Code | |||||||
| Day time telephone number | |||||||
| Order Code | Quantity needed | Order Description | Price of Item | |
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Postage Rates based on order value* |
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£0.00 - £9.99 = £4.00 postage |
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£10.00 - £24.99 = £5.00 postage |
Total cost of ordered items |
£ |
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£25.00 - £74.99 = £6.00 postage |
Plus Postage |
£ |
| £75.00 - £149.99 = £7.00 |
TOTAL TO PAY |
£ |
| £150.00+ = £8.00 |
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Card Holders full name |
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Sec Code |
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Card Number |
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Exp Date: |
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Address if different from above including house number and post code |
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Valid Date: |
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Issue No: |
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