Please print this form and fax it to Stelvio as soon as possible. If you are unable to make payment electronically, please post the order form together with your payment to the address below after you have faxed it.
Please hurry, as time is limited! Stelvio bank account code is: Barclays Bank, Fakenham Branch - Sort Code 20-30-81 Account Number 80917141
BIC & IBAN codes on request from tony@churly.co.uk Cheques must be made payable to Stelvio
Stelvio The Little House 18 Gladstone Road Fakenham Norfolk NR21 9BZ Tel. 01328 863350 (open 7am - 9pm, 7 days a week) Fax. 0871 2771496 Email. orders@ stelvio.org.uk Entry Number .............................................. If you have not already got an entry number then get one here Name .............................................................. Address ......................................................... .......................................................................... .......................................................................... .......................................................................... .......................................................................... Telephone Nos. Daytime ............................................................. Evening .............................................................. Mobile ................................................................
Email Address ..................................................
Please provide me with the following Stelvio 2004 merchandise:
Total: .....................................
My payment details are as follows:
Total Amount paid: ...............................................
I am paying by Cheque/Automated Credit Transfer/Cash My automated credit transfer reference is ...............................
Signature ...................................................................................................