| Product No. _______________________ | Description_________________________ |
| Price of item:£______________________ | See Item Price List by Clicking Here |
| Price of Delivery:£___________________ | See Delivery Price List by Clicking Here |
| Total:£____________________________ | |
|
Deliver To: |
|
| Name______________________________________ | Tele:__________________________ |
| Address_______________________________________________________________________ | |
| City_______________________________________
Post Code____________________________ |
County____________________________
E-mail Address_____________________ |
|
Bill To: (if different than deliver to) |
|
| Name______________________________________ | Tele:__________________________ |
| Address_______________________________________________________________________ | |
| City_______________________________________
Post Code____________________________ |
County____________________________
E-mail Address_____________________ |
|
|
Circle form of payment Certified/Cashiers Check Money Order Personal Check Postal order |
|
Comments or special requests:______________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Print this form, fill out and send with payment to:
Access Appraisals Ltd.
The White Cottage
Stourton
Shipston-on-Stour
Warwickshire.
CV36 5HG
tel: 01608 685039
E-Mail to
info@wheelchair-ramps.co.uk