Please ensure all details are completed then Fax to +44 (0)1422 367609
Shoes International Fax Order Form
| Customer details |
| Name as appears on Credit Card |
| Card billing address |
| Post Code/Zip |
| Country |
| Email |
| Contact Telephone No. (This number is essential) |
| Return Fax No. |
|
| Delivery address |
| Delivery address (If different) |
| Post Code/Zip |
| Country |
|
No charge for shipping for orders from the UK
| Make | Style | Size | Colour | Number | Price |
| | | | | | |
| | | | | | |
| | | | | | |
| Total | | |
| Shipping cost @ per pair = | |
| Total to be billed from card | |
|
| Credit Card Details |
| Type (Visa / MasterCard / Switch / AmEx) |
| Card Number | | | | | | | | | | | | | | | | | | | |
| Valid from / |
| Expires / |
|
| Confirmation of receipt |
| Confirm receipt of order by Fax (YES/NO) or by email (YES/NO) |
|
Please sign and date.
I confirm the above order, signed _________________________ date _________________