This Form can be used to order any of our products either by:
Fax, Mail, E-mail , or Phone . Print a copy and Fax or attach a copy and E-mail , Mail or use for information necessary to call . Thank You
Date of Order _____/_____/____ Your Account No ( If Known )----------------
Your Last Name _______________________First Name __________________
Mailing Address____________________________________________________
__________________________________________________________________________
City____________________County_________________Post Code__________
Fax #_(_____)____________Daytime Phone _(______)______________
E-Mail ____________________________
Credit Cards_________VISA___________Mastercard (Circle)
Please write the Number clearly____/__/__/__/__/__/__/___/__/___/___/___/___/__/__/___/
Expiration Date _____/_____/____/____/
Name as it Appears on Card_________________________________
Our Fax Is Secure and your Credit Card Information is Safe !
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Product code__________Quantity__________Price each__________total____
Please add £2.25 ( For UK ) if under £30, otherwise postage free___________
Total___________
Plus VAT @ 17.5%___________
Total Cost___________
If more Space is needed please feel free to attach additional sheets.
Orders or Can be Faxed 24 Hours Day+44 (0) 1363 777992
E-mail Can be Sent 24 hours a day to sales@bali-images.co.uk
Orders can be phoned 8am to 8pm +44 (0) 1363 775721
Mail Address :