Countryman John - Tile Art Order Form

Please click here to download order form and price List in ‘®Adobe Acrobat Reader’ format, or print off form below and post or fax to: Countryman John, Unit 5e, North Lonsdale Rd. Ind. Estate, Ulverston, Cumbria, LA12 9EB. Tel: 01229 581010 / 015394 41129. Fax: 01229 584203. E-mail: office@countrymanjohn.co.uk Please allow 3 weeks from date of order to delivery
Design	No. of Tiles	Colour	Price








	Total		£
	P&P for picture tiles*		£
	P&P for plain tiles**		£
	TOTAL PAYABLE		£
* Picture Tiles: Up to 10 printed tiles - £8.50. Over 10 printed tiles - £20.00
Plain Tiles: 1 - 2 Boxes: £22.00 3 - 5 Boxes: £38.00 6 - 8 Boxes: £50.00.** (44 per box)

FORM OF PAYMENT

Cheque – payable to Countryman John.

Debit /credit card

Switch

Visa

Master Card

Card Number

Switch Only

Expiry Date:

CVC*:

Switch Issue No:

Switch Start Date:

*CVC - the last three digits of the security number on reverse of card

Signature:

Personal Collection:

Name:

Address:

Postcode:

Daytime Phone Number: