Koi / Aqua order form

KOI & AQUA RANGE ORDER FORM

Your details

Name:

Address:

(cont)

(cont)

(cont)

(cont)

Order date:

E-mail:

KOI / AQUA ORDER FORM

Item

Quantity

Unit price

Item total

Koi - large vase
£ 200

Koi - lamp base
£ 200

Koi - "fish-lip" vase (7")
£ 135

Koi - tall "fish-lip" vase
£ 95

Koi - powder bowl (gold)
£ 70

Koi - powder bowl (platinum)
£ 70

Koi - posy vase
£ 45

Aqua - dragonfly
£ 95

Aqua - angel fish
£ 95

Aqua - sea horse
£ 100

Aqua - dolphin
£ 100

Item total

UNITED KINGDOM
£ 5

Postage & packing
(see details to left)

EUROPE
£ 5

USA
£ 20

REST OF THE WORLD
£ 25

Grand total

Payment may be made by UK cheque or Postal Order made payable to Marie Graves, or by International Money Order drawn on a UK bank in pounds Sterling.

Please tick to indicate

method of payment:
UK cheque

UK Postal Order

International
Money Order

If you have given us an e-mail address, we will confirm receipt of your order and advise you when the item(s) you have ordered are despatched.

Please print out this form and send it, together with your remittance to :-

Marie Graves, 53 George Avenue, Meir, Stoke-on-Trent
Staffs ST3 6DQ, United Kingdom

Your details
Name:
Address:
(cont)
(cont)
(cont)
(cont)
Order date:
E-mail:

KOI / AQUA ORDER FORM
Item	Quantity	Unit price	Item total
Koi - large vase		£ 200
Koi - lamp base		£ 200
Koi - "fish-lip" vase (7")		£ 135
Koi - tall "fish-lip" vase		£ 95
Koi - powder bowl (gold)		£ 70
Koi - powder bowl (platinum)		£ 70
Koi - posy vase		£ 45
Aqua - dragonfly		£ 95
Aqua - angel fish		£ 95
Aqua - sea horse		£ 100
Aqua - dolphin		£ 100
Item total
UNITED KINGDOM	£ 5	Postage & packing (see details to left)
EUROPE	£ 5
USA	£ 20
REST OF THE WORLD	£ 25
Grand total