David Morbey Timpani & Percussion
CUSTOMER ORDER - Web site form  03/2011
Date:
Name:
Address:

 

Telephone:
Fax:
email:
Qty Model Shaft diameter Special requirements Price Total
. . . . .  
Please specify your chosen currency:                                           Sub Total  
Add Mailing .
Sub Total .
Order Total .
Payment details:
Cheque   International Money Order Please enclose your payment, thank you
Direct to our bank (details upon request)
VISA CREDIT VISA DEBIT VISA ELECTRON  
MASTERCARD  
Card Number          
Card expiry date                      
Card security number (last 3 digits on signature strip)                           
Cardholder name and billing address:

 
Cardholder signature:

Please fax this form to:   David Morbey Timpani & Percussion  01224 212557  (International: +44 1224 212557)
or mail to:    55 Braemar Place,  Aberdeen,  AB10 6EQ,   United Kingdom 

03/11