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Order Form for Georgina Barrow Natural Paints
Relics of Witney Ltd,  35 Bridge Street, Witney, Oxon. OX28 1DA England.     

How to use this form
 Either fill in and copy the form and paste it info your e-mail package
Or complete the form, print it out and fax / post it to us. ( You may also phone in your order ) 01993 704611
Contact/Delivery Details 

N.B. The carrier will require a signature on delivery of your order, please ensure there is someone to receive it.

Title:       Surname:     Initials: 

Delivery Address:
Line 1: 
Line 2: 
Line 3: 
Line 4: 
Post Code:  Country:

Daytime Phone Number:

Fax:
E-mail details:
Hand painted Colour Card £4.50 inc p&p UK Mainland or £6.00 Overseas 

Payment Details

Payment Method:   Cheque made payable to Relics in G.B. Pounds
                        or  Visa           MasterCard           Switch           Delta        

Cardholder Name: Cardholder Signature: _______________________
Card Number:                
Start Date: /  

Expiry Date:

 /   Switch Issue Number:

Cardholder Home Address if different from delivery address above.
Post Code:  

 
Paint Code Number & Colour Description including size and type Qty. Total Price
Total Order Value

Post and Packing
UK Mainland Only. 

 Sample Pots up to 3 £3.00
All Other Orders      £8.00 Upto 20 KG		 P & P

Please note 5 litres = 8 KG Payment Total