Postal Order Form

Please print off and fill in the form: View an example

Name:

Address line 1:

Address line 2:

Town/City:

County:

Post Code:

Telephone No:

E-mail:

Mobile No (optional):

Fax (optional):

SET NUMBER	SET	PRICE	QTY.	TOTAL
	£	p
			TOTAL

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: _______________________