Map Order Form for printing and posting or faxing to EWP

Map Name:Code:Quantity:Cost:
Map Name:Code:Quantity:Cost:
Map Name:Code:Quantity:Cost:
Check the price scales: UK residents or overseas carefully, note currency options.Total:
Currency:
Your Details
Mr/Mrs/Ms
 		Surname
 		First Names
 
Phone
 		Fax:
 		Email:
 
Address
Street:
Town:
Postcode:State:Country:
Payment:
   Option 1 (cheque payment):
I enclose a cheque for the above total of ........................... (converted to GB pounds) made out to "EWP".

   Option 2 (credit card payment):
Please debit my credit card for the total above £...........
(Card payments must be made in GB£).
Card Type and Number (Visa, Mastercard or Switch only)
 		Issue Number
 		Valid till (mm/yy)
 
Cardholder's name (as on card), address and telephone (not mobile) if different to above:

 


 
Signature(s) ______________________________    Date _________
Send this completed form with a cheque or credit card details to:
EWP, Haulfryn, Cilycwm, SA20 0SP, United Kingdom.
To discuss your purchase and/or give us your credit card details by phone ring: Tel. +44 (0) 1550 721319
This form may be faxed to us - suitable for credit card payments Fax. +44 (0) 1550 720053
Email: ewp@ewpnet.com - do not send credit card details by email.
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ALW 16/6/05