ORDER REQUIREMENTS

	QTY	PRICE
Weight belt (without lead) £ 25.00	_____	_______
Please state waist size here .........................................	_____	_______
Lead (only available for UK and BFPO Orders) @ £1.50 per 1lb weight	_____	_______
Post and Packing costs: UK Mainland and BFPO( belt only with no weights) £ 2.00 Europe (Belt with no lead) £3.00 Rest of World (Belt with no lead) £6.00 Belt complete with filled shot bags £ 10.00	_____	_______
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)

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CARD HOLDERS SIGNATURE..................................................................................

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

POST: