Fax Order Form - for customers who prefer this to using our secure servers

FAX ORDER FORM

Print this form by clicking on this page and the pressing 'print' and then fax it to us on:
In the UK: 01992-578 485
Outside the UK: Int+44-1992-578 485

Item	Quantity	Price Each	Order $ or Ł
Pens - Please give Reference and describe the pen
(1)
(2)
(3)
(4)
(5)


TOTAL VALUE OF ORDER

Full Name
Company
Street Address
Town
State/County/Zip
Country
Phone
Fax
Credit Card Type	[ .......] [........] [........]
Card Number	......................../......................../......................../........................
Expiry Date	............../............ Issue No for Switch .............. Security Code**...................
Signed:

** The Security Code is the last three numbers on the signature strip on the back of the card

Please note that we do NOT accept Amex for orders in US Dollars or Euros