Orders via Cheque, Postal Orders & FAX Fill in all the fields below and then Click the Print This Page Button. Post or Fax this page to us with your Card Details OR payment made payable to Slimming & Nutrition Consultancy Ltd. Please note that Orders via Cheque / Postal Order / Bank Draft must be made out in UK£ Sterling. |
Title, Name & Surname: | |
Address & Post Code: | |
STD and Tel: | |
E-mail address: | |
Have your ordered from us before? | |
Card Details if paying by Credit or Debit Card: - Card Number:
- Valid From:
- Expire Date:
- Issue Number (if applicable):
- Security Number (last 3 numbers on signature strip):
- The Cardholders' Name (as written on the card):
- Card issuing Bank or Institute:
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(add UK£ 0.99 for postage to the total) Total = | |
Post Details & Payment to: Slimming & Nutrition Consultancy Beekay House 6C ST. Catherines Road Southbourne Bournemouth Dorset BH6 4AA UNITED KINGDOM | FAX this form to: 0870 762 7453 - Remember to Date & Sign this page if you are faxing this Order Form with Card details.
- You MUST write your Cheque Guarantee Number on the back of the chq you send us.
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