Please Print This Form And Fill Out By Hand.
(You may need to adjust your printing configuration. Recommended print size. 70%)

Post This Form With Your Cheque,
PO Or Credit Card Details To:

MindZone. PO Box 161. Borehamwood.
WD6 2ZG

Or Fax Credit Card Orders only To:

Fax: 0181-905-2332

Please print clearly in BLOCK CAPITALS. 
All cheques and PO's in pounds sterling. 
Please do not send cash.
UK Orders Only.

(Please DO NOT place an order! This is not a live comercial site. It is for demonstration only.)

 

 

Product Order Form

Product

Unit Cost

Quantity

Total Cost

Football 1

£7.99

|

£

Football 2

Coming Soon

N/A

N/A

Football 3

Coming Soon

N/A

N/A

UMA T-shirt

Coming Soon

N/A

N/A

UMA Baseball Cap

Coming Soon

N/A

N/A

Grand Total (free post and packing)

£


Payment By Cheque

I enclose a cheque / PO No. ___________________for amount

£

crossed and made payable to MindZone.


Payment By Credit Card

Card Type
(please circle one)

VISA / MASTERCARD / DELTA / SWITCH

Name on Card

|

Card Number

|___|___|___|___||___|___|___|___||___|___|___|___||___|___|___|___|

Card Expires

|

Switch issue No.

|

Daytime Telephone

(code____________)

Evening Telephone

(code____________)

Cardholder Signature

|


Customer Details

First Name

|

Last Name

|

Date of Birth

DD:

MM:

YY:

Address

|

|

|

Town / City

|

County

|

Post Code

|

Email Address

|

Please tick box if you are purchasing for someone else.

Please tick box if you do not wish to receive future promotional material from MindZone or other companies.


Normal Delivery 7 to 10 days, Please allow up to 28 days.

Thank you for your order

Ultimate Mental Attitude!!!

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