Fax Form

Margaret Anne Floral Designs

Please print this form.
Complete it using capital letters and fax to:

0161 368 0608

From outside the UK:

+44 161 368 0608

Please deliver to:

Name.....................................................................
Address..................................................................
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.........................................................................
.........................................................................
Postcode..........................................
Telephone........................................
Delivery Date.................................

Message..................................................................
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Description of Order......................................................
...........................................................................................
Value £..........................................

Ordered by:
Name.....................................................................
Address..................................................................
.........................................................................
.........................................................................
.........................................................................
Postcode.......................................
Country........................................
Telephone.......................................
E-mail...........................................

Card Type: Access - Visa - Delta - Switch - American Express - Mastercard - Diners
Cardholders Name...................................................
Card Number............................................................
Expiry date..../....
Start date..../....
(Switch Issue Number.......)

Notes...................................................................
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