R J & R S GILLETT T/A STITCH PICS
POBOX 2744
 NUNEATON
CV10 7YG
TEL. ++44 (0)24 7638 3072 FAX. ++44 (0)24 7638 3081

To order off line: print off this page and either Phone, fax or post the information.
E Mail ord@stitchpics.co.uk (NB E-mail is not secured for credit card information)

ORDER FORM

NAME........................................................................................................

PLEASE USE BLOCK CAPITALS

ADDRESS.............................................................................................................................................

...............................................................................................................................................................

It would help if you could give your telephone number in case of any query..............................
HOW
MANY		 DESCRIPTION OF GOODS/DESIGN TITLE REF. SIZE PRICE
         
         
         
         
         
         
         
         
         
         
         
         
         
         
  Please continue on a separate sheet if required      

TOTAL OF GOODS PURCHASED  
PLUS HANDLING CHARGE for small orders
(£1.00 FOR ORDERS UNDER £5.00) in addition to carriage		  
CARRIAGE (£1 UK & BFPO - £3.50 Rest of Europe - £4.50 Worldwide)  
GRAND TOTAL  

PLEASE MAKE CHEQUES PAYABLE TO STITCH PICS




PAGE 2 FOR USE IF PAYING BY CREDIT CARD
(MINIMUM FOR CREDIT CARDS £5.00)

Please circle one of the following.
VISA
MASTERCARD
SWITCH / MAESTRO
Start Date ___/___ If Using Switch:- ISSUE NO.__ __

CARD NO. __ __ __ __ /__ __ __ __ /__ __ __ __ / __ __ __ __ /__ __ __ __

SECURITY No.__ __ __ What is This? EXPIRY DATE ____/____

SIGNATURE..........................................................

CARD HOLDERS NAME & ADDRESS IF DIFFERENT: .....................................................................................

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PROPRIETORS R & R GILLETT E & O E

REGISTERED FOR V A T NO. 620 9226 61