 |
| Postal Order form |
| Please print off and fill in the form with the delivery address: |
|
Name: |
John
Davis |
|
Address line 1: |
33,
Mountain Road |
|
Address line 2: |
Latham
Green |
|
Town/City: |
Buckley |
|
County: |
FLINTSHIRE |
|
Post Code: |
CH7
5GT |
|
Telephone
No.: |
(01244)
548867 |
|
E-mail: |
JAD1@hotmail.com |
|
Mobile
No. (optional): |
07812345678 |
|
Fax
(optional): |
- |
|
SET NUMBER |
SET SIZE |
SET PRICE |
QTY. |
TOTAL |
|
|
|
|
£ |
p |
|
|
|
Set
#1 (Small square coals) |
10 |
7 |
00 |
2 |
14.00 |
|
Set
#3 (Large square coals) |
10 |
11 |
00 |
1 |
11.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
25.00 |
Please send completed form with cheque to:
(Please makes cheques payable to Gas Glo Ceramics)
|
Clwyd Refractory Fibres, |
Please tick this box and sign below to show |
|
|
Unit 5, |
That you have read the disclaimer and agree |
|
|
Spencer Industrial Estate, |
To the terms and conditions. |
|
|
Buckley, |
(Items can’t be sent without the box being |
|
|
FLINTSHIRE |
Ticked and the space being signed) |
|
|
CH7 3ET |
|
|
| Signature: _______________________ |