|
Please
use this form if you wish to FAX your order |
|
FAX to: |
|
Complete this form using your keyboard,
then print, SIGN and fax to the above number
|
|
YOUR ORDER |
|||
|
I wish to order ONE
Crusade board game |
|||
|
CONTACT DETAILS |
|||
| Your E-mail Address | |||
|
CREDIT CARD DETAILS |
|||
|
I authorize Dal Cassian (gamesmaker) Ltd., to debit my Visa/MasterCard with the sum of £29.95 |
|||
| Name on Credit Card |
We accept |
||
| Credit Card Number |
the following credit cards |
||
| Start Date |
|
||
| Expiry Date | |||
| Card verification number | What is my card verification number ? | ||
|
This is a 3-digit number
found printed in the signature panel on the back of your credit card. It is the last three numbers immediately following the last few digits of your account number. |
|||
| Signature | |||
|
DELIVERY DETAILS |
|||
|
N.B. For security reasons when paying by credit card the delivery address must be the same as the card billing address |
|||
| Name | |||
| Address | |||
| Town/City | |||
| County | |||
| Country | |||
| Postcode | |||
| Tel | |||
|
Your order entitles you to free
membership of our Introduce-a-Friend programme |
|||
|
END OF FORM |
|||