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| Style(s) required | Indicate if male or female | *Custom size | Colour Preferences | Price |
| Post and Packing: UK Mainland and BFPO £1.00 per item plus 50p per additional items Europe £ 2.00 per item Rest of the world £ 3.00 per item | ||||
TOTAL ORDER VALUE | ||||
DESPATCH AND PAYMENT DETAILS
Name............................................................................................................................. | |
Delivery Address............................................................................................................. | |
..................................................................................................................................... | |
Country........................................................ | Post/Zip Code.......................................... |
Telephone.................................................... | Fax........................................................ |
| Email........................................................... | |
| Mobile.......................................................... | |
| Date order placed......../...../..... | |
| Unfortunately, we aren’t able to offer ordering on line at the present time, but you can pay by the following methods: - |
| 1. UK residents-cheque (sterling), banker's draft, Master Card, Visa Card, Delta Card (Sorry we don't take Switch!) 2. All other countries - Master Card, Visa Card, Delta Card |
| I enclose a Cheque for the full order value of £ _____________ Made payable to ORIGINAL LIZARD Or: Please debit my credit card the amount of £ ______________ Credit card details: MASTER CARD / VISA / DELTA CARD HOLDER NO: |
| CARD EXPIRY DATE __/__/____ |
| CARD HOLDER'S ADDRESS AND POST/ZIP CODE (if different from the delivery address above) |
| ........................................................................................................................... |
| ........................................................................................................................... |
| CARD HOLDER'S SIGNATURE.................................................................................. |
Please complete the above and return to us by one of the following methods:
POST:
ORIGINAL LIZARD