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|
ORDER REQUIREMENTS
| QTY | PRICE | |
| Lifejacket with belt £54.99 plus £5.00 p+p | _____ | _______ |
| Lifejacket and belt with optional pouch £64.99 plus £5.00 p+p | _____ | _______ |
| Optional pouch sold separately £15.00 plus £1.50 p+p | _____ | _______ |
| Replacement gas cylinder £15.00 plus £3.00 p+p | _____ | _______ |
|
Postal information: |
_____ | _______ |
| TOTAL ORDER VALUE | _____ | _______ |
|
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