Countryman John - Tile Art Order Form

The Rural Workshops, Lake Road, Coniston, Cumbria, LA21 8EW
Tel: 015394 41129. Fax: 015394 41973
E-mail: office@countrymanjohn.co.uk

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, The Rural Workshops, Lake Road, Coniston, Cumbria, LA21 8EW Tel/Fax: 015394 41129. Fax: 015394 41973. 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		£ 8.50
	P & P for plain tiles**		£
	TOTAL PAYABLE		£
Plain Tiles: 1 - 3 Boxes: £13 4 - 6 Boxes: £22 7 - 9 Boxes: £35 10 -12 Boxes: £45**

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: