Order form for brass / aluminium numbers

Please print this order form and send it with your cheque to Shaun Price, Country Ways, High Bickington, Umberleigh, Devon EX37 9BJ or fax it with credit card details to 01769 560819  Date.................................. Name....................................................................  Address...........................................................................................................  ........................................................................................................................  ...................................................................Post Code....................................  Tel.................................................... Fax........................................................  e-mail............................................................................................................. Numbers to be carved into the sign .......................................................................................... Font  ................................................................................ Brass / Aluminium Includes holes drilled. Extra Text if required............................................................................... Border description if required.................................................................. Picture/Motif Code if required........................................ Backing Board Yes / No Height............................Length...............................   £.................. Decorative motif/ Picture @ £2.75 Please print out decorative design page and mark the symbol  £................. P&P - UK £2.48 Worldwide airmail - £3.03 with backing board - UK £4.13 Worldwide airmail - £5.78  £............... Please make cheques payable to Shaun Price                    Total  £.................  Card Number.........................................................  Expiry Date..................  Start Date........................ Sec no...................  Issue Number..................  Card Holders Name..........................................................................  Signature...........................................................................................  Signs include VAT no. 682 5902 13