| David Morbey Timpani & Percussion | |||||
| CUSTOMER ORDER - Web site form | |||||
| Date: Name: Address:
Telephone: |
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| Qty | Model | Shaft diameter | Special requirements | Price | Total |
| . | . | . | . | . | |
| Please specify your chosen currency | . | ||||
| Sub Total | |||||
| Add Mailing | . | ||||
| Sub Total | . | ||||
| Order Total | . | ||||
| Payment method: | |||||||||||||||||||
| Cheque: | If mailing please enclose your Cheque or International Money Order | ||||||||||||||||||
| International Money Order | |||||||||||||||||||
| Direct to our bank | (details upon request) | ||||||||||||||||||
| VISA | |||||||||||||||||||
| Mastercard | |||||||||||||||||||
| Card Number: | |||||||||||||||||||
| Card expiry date: | |||||||||||||||||||
| Card security number (last 3 digits on signature strip) | |||||||||||||||||||
| Cardholder
name and billing address:
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| Cardholder signature: | |||||||||||||||||||
Please fax this form to David Morbey Timpani & Percussion
01284 830500 (International: +44 1284 830500)
or mail to: Old Mill House, Shimpling Road, Hartest,
Bury St.Edmunds, Suffolk, IP29 4ET, United Kingdom