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: Hit Counter

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

Reggie's Den is a Trading Name of Detour Mail Order
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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