Scots Corner Order Form

TO:   SCOTS CORNER
  1 Normandy Avenue, Hamilton, New Zealand
  Ph/Fax: +64 7 843 5264
  Email: rossmccl@clear.net.nz    

FROM:   Name:    
Street address:    
  Suburb:
City:
Country:  Post code:
  Phone:  Fax:
Email address:    
     
Payment method:      
Name on card:  

Card number:

 Expiry date:  
Signature:    

Please complete the details above, then print this page and fill in your order.

Quantity

Description of Item (product id and name)
Clan Name
Unit Cost
TOTAL COST
       
       
       
       
       
       
       
       
       
       
Postage (to be added at cost):
  
Total:
  

Print this form and fax to Scots Corner on +64 7 843 5264

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