21st ANNIVERSARY POT ORDER FORM

PLEASE FILL IN THE FOLLOWING FORM AND CLICK SUBMIT.

 WE WILL THEN EMAIL YOU WITH AN INVOICE OF THE TOTAL COST, FROM THIS EMAIL YOU CAN PAY DIRECTLY THROUGH A SECURE SERVER  USING A PAYPAL ACCOUNT OR A BANK OR CREDIT CARD.  

 

 

Quantity of Pots:

 Colour of pot: Grey or Grey/Green

 

 

        PLEASE PROVIDE THE FOLLOWING CONTACT INFORMATION:

Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
Mobile Phone
E-mail

 

SHIPPING ADDRESS IF DIFFERENT FROM ABOVE
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Copyright © 2007 [Walsall Studio ceramics]. All rights reserved.
Revised: September 26, 2008