MAIL/FAX ORDER FORM
D.L. SPECIALIST TACKLE
12 Wilson Close, Tarleton, Preston, PR4 6DE, U.K.
01772 - 812036
PAYMENT ACCEPTED BY
CHEQUE
POSTAL ORDER
VISA
MASTERCARD
PLEASE TICK AS APPLICABLE
CHEQUES (UK ONLY) PAYABLE TO "D.L.SPECIALIST TACKLE" PLEASE
CUSTOMER DETAILS
NB: If ordering by credit or debit card this address must be that of the card holder.
NAME:
ADDRESS:
POST CODE:
PHONE NO.:
Visa/Mastercard (credit or debit card) number
(SORRY, SWITCH CARDS CANNOT BE ACCEPTED)
Visa/Master card expiry date
Month:
Year:
Signature:
ORDER
ITEM
(Including pack size if applicable)
SIZE
COLOUR
ALT.
COLOUR
UNIT PRICE
QTY
(Units)
TOTAL
CARRIAGE £3.00
(
£20.00 ON ALL U.K. ROD ORDERS,
OVERSEAS CARRIAGE 10% ON SMALL ORDERS - RODS ETC. BY ARRANGEMENT,
FREE
ON OTHER ORDER TOTALS OVER £25)
OFFICE USE ONLY:
TOTAL