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Text File  |  1996-03-07  |  1KB  |  54 lines
  1. Virtual London Fax order form.
  2. ------------------------------------------
  3. Please print this form out, fill it in, and fax or send it to:
  4.  
  5. Virtual London Ltd,
  6. 2-5 Old Bond Street,
  7. Mayfair,
  8. London
  9. W1X 3TB
  10. Great Britain
  11. Tel & fax: ++44 181 930 0769
  12.  
  13.  
  14. Name:____________________________________________________
  15.  
  16. Address:_________________________________________________
  17.  
  18. _________________________________________________________
  19.  
  20. _________________________________________________________
  21.  
  22. Tel:____________________
  23.  
  24. Fax:____________________
  25.  
  26. Email:___________________
  27.  
  28.  
  29. I would like to order ____ copies of Virtual London on CD ROM at ú29.99 each including postage. 
  30.  
  31. Please debit my ________________  card (Visa/Mastercard).
  32.  
  33. Card Number_____________________________
  34.  
  35. Expiry date_____________________________
  36.  
  37.    
  38.  
  39.  
  40. Signed__________________________________  Today's Date________________
  41.  
  42.  
  43. Delivery address if different from above,
  44.  
  45.  
  46. Name:____________________________________________________
  47.  
  48. Address:_________________________________________________
  49.  
  50. _________________________________________________________
  51.  
  52. _________________________________________________________
  53.  
  54. Thank you for your order which will be sent immediately!