| Name | : |
| Address | : |
| : | |
| : | |
| Postal Code | : |
| Country | : |
| Telephone | : |
| : |
| Quantity | Description | Cost |
| |
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| Postage & Packing £3 for up to 1kg ; £5 for 1-2kg ; £7 for £2-5 kg in UK. Overseas charged at cost. |
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| Total Payment Due |
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Payment Method (tick box)
| |
Cheque enclosed (payable to "Chiltern Games & Puzzles") | ||
| Please debit my Visa /
Mastercard account for : |
£ | ||
| Card Number: |
Expiry date | ||
Signature: |
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Return this form to : Chiltern
Games & Puzzles |
or fax to : 01691 649026 (from UK) +44 1691 649026 (from overseas) |