Name: ......................................................
Address: ...................................................
.................................................................
........................ Postcode: ........................
Product No. |
Quantity |
Lens Power |
Price |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
- |
Goods Total: |
£ |
£2.50 Postage/Packaging: |
£2.50 |
TOTAL: |
£ |
|
|
Name on card: .........................................
Card No: .................................................
Expiry Date: ............................................
Total amount to be debited: £.....................
|
The Reading Spectacle Co.
PO Box 119
Cowes
Isle of Wight
PO31 7ZU
|
|