Boat Race Collection Order

Print or fill out, and fax this form
Please send me:

Item no.	Description/Colour		   Qty	 Price	Total	

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Add postage and packing: ______________________________________________

			Total price of order:    ______________________

My details

Name:__________________________________________________________________

Address:_______________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

I wish to pay by Visa____ Access_____ Mastercard_____ Other____________

Credit card number:    __/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/

Credit card expiry date:__/__/  Signature______________________________

I authorise you to debit the total of  _____________ __from my account.

Postage and packing:


Order address:


We guarantee that all orders will be despatched within 28 days of receipt.

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