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T-SHIRTS ORDER FORM
Delivery and P&P costs:

ORDER REQUIREMENTS
   SIZE QTY PRICE
"Addicted to” Adrenalin T-shirt (Unisex)
colour black size M/L/XL .................................£ 18.00
_____ _______ ________
“Addicted to” Adrenalin T-shirt (Unisex)
colour white size M/L/XL ................................£ 18.00
_____ _______ ________
“Addicted to” Testosterone T-shirt (Unisex)
colour black size M/L/XL .................................£ 18.00
_____ _______ ________
“Addicted to” Testosterone T-shirt (Unisex)
colour white size M/L/XL ................................£ 18.00
_____ _______ ________
       

Post and Packing costs:
UK Mainland and BFPO £ 1.00
Europe £ 2.00
Rest of the World £ 3.50

    ________
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 HOLDERS SIGNATURE..................................................................................

Please complete the above and return to us by one of the following methods:

POST:

ORIGINAL LIZARD
11 HUMBERDALE DRIVE
NORTH FERRIBY
EAST YORKSHIRE
ENGLAND
HU14 3LB
TELE/FAX: + 44 (0) 1482 635483
E-MAIL: info@original-lizard.com