GLENCALL INTERNATIONAL
One Lomond House, GlenLomond, Kinross-shire, KY13 9HF
Tel; 01592 840853 Fax; 01592 840005
Chelsea /order form- _________________________________
Please make cheque payable to GlenCall International and send to the address at the top of this page;
If paying by Credit card we accept Mastercard/ Visa/ Access/ Delta/ Switch/Maestro/ Amex
Please fill in the following form and either, send to us at the address above, or fax us, number above; You can also order on-line http://www.glencall.co.uk/1gi/pillh.html
Or you can telephone or fax your order on the numbers above
Please enter the following information in CAPS
- NAME
______________________________________________________________________
- ADDRESS
______________________________________________________________________
- POST CODE
_________________________________________________________
- TEL *
_________________________________________________________
If paying by credit card we also need the following details
- NAME OF CARD HOLDER (exactly as it appears on card)
_______________________________________________________
- CARD NUMBER
________________________________________________________
- EXPIRY DATE
_____________________________________________________
- 3 digit security code
on back of card ------------------------------------
- SIGNATURE OF CARD HOLDER
________________________________________________________
(If paying by switch please complete the following)
- ISSUE NUMBER (IF APPLICABLE)__
________________________________________________________
- START DATE (IF APPLICABLE)__
________________________________________________________
PLEASE COMPLETE THE FOLLOIWNG
- BOX NAME AND CODE
_________________________________________________________
- COLOUR OF BOX
_________________________________________________________
- NUMBER YOU WISH ON BOX (IF APPLICABLE- A name is not available on this box)
__________________________________________________________
- COLOUR CHOICE OF NUMBER (GOLD, BLACK OR WHITE)
__________________________________________________________
- Chelsea comes with self threading screws and drill bit for drilling through bars; If
- You require the clamp fixing method please add an extra £33.49 to your order; Let us
- Know below, if you have round or square bars; If round bars tell us the bar diameter in mm;
- If square bars tell us the width of bar in mm;
___________________________________________________________
- QUANTITY
____________________________________________________________
-
TOTAL COST OF ORDER
_____________________________________________________________