Please print this page and mail or
fax it to:
NVM DIGITAL, P.O.BOX 1, Bentham,
Lancaster, LA2 7GA, England Phone/Fax +44 (0) 15242 62445
Please make cheques and postal
orders payable to NVM. For
non-UK destinations please add £1.00 per item for shipping
and pay by
Credit Card or Sterling Banker's Draft. Please enter the
items you require.
| ITEM | Price Each | Number | Total |
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
| £ | £ | ||
|
TOTAL ENCLOSED
|
£ | ||
| Expiry Date | |
| Last three digits of security
number
On reverse side of card, usually by signature |
|
| Name as on the Card | Valid from date
(if available) |
| Delivery Address | Postcode |
| Signed | |
| Date | |
| Telephone |