home > The swopper > orderform

ConceptFurniture.com  64 Knightsbridge  London   SW1X 7JF   United Kingdom
Telephone: +44 (0)20 7823 9090   Facsimile: +44 (0)870 125 9464   E-mail: admin@conceptfurniture.com

THIS FORM IS NOT ELECTRONICALLY SUBMITTABLE. PRINT IT OUT AND MAIL, PHONE OR FAX IT IN WITH YOUR PAYMENT.

SHIPPING AND HANDLING INFORMATION

Customer Details,
Same name and address relevant to your credit card.

Name______________________________________

Company___________________________________

Address____________________________________

_____________________ Post code ____________

City________________________________________

Country____________________________________

Phone (day)_________________________________

(Evening)___________________________________

Delivery Details,
Use only if different from customer details

Name______________________________________

Company___________________________________

Address____________________________________

_____________________ Post code ____________

City________________________________________

Country____________________________________

Phone (day)_________________________________

(Evening)___________________________________

E-mail

PRICES QUOTED INCLUDES  VAT AND  DELIVERY WITHIN THE EC [ SEE TERMS AND CONDITIONS]

ORDERING INFORMATION

model

Colour

Qty

Price

Total

______________________

_____________________________

______

__________

__________

______________________

_____________________________

______

__________

__________

______________________

_____________________________

______

__________

__________

METHOD OF PAYMENT

  Delivery Cost:

0,00

VAT:

0.00

____ Enclosed Is Payment- Check Or
U.K postal order (payable to Bonbon Trading Ltd)

Order Total:

Visa  ____ MasterCard   ____  Delta  ____ Switch   ____ Issue no.        _________ 

Credit Card No.
 Valid From.   _____ /____ (Month/Year)
 Expiry Date. _____ /____ (Month/Year)

Name as on card.

Signature and Date.