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

£13.50

P & P for plain tiles**

£

TOTAL PAYABLE

£

** Plain Tiles: 1 - 3 Boxes: £14.50 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: