print | close
Foxgloves Mail Order Form

Print the form and enter your order details. When completed send the form to:

Foxgloves
3, West Street
Ashburton
TQ13 7DT

Please enclose payment with your order.

We will respond with a confirmation of your order as soon as we can.

Goods

Code
(if found)		 Description Colour/Design
(if applicable)		 Size
(if applicable)		 Qty Price (£) Total (£)
             
             
             
             
             
             
             
Total goods  
Post and packing 3.95
TOTAL PAYMENT  

Delivery address

Name 
Address1 
Address2 
Town/City 
County 
Postcode 

Contact details (to be used if there is a problem with you order)

Telephone 
Email 



Payment

Payment Method (please tick)  Cheque with order    Credit/Debit card

Card Details (if payment by credit/debit card)

Card Type (please tick)   VISA    MASTERCARD    SWITCH / MAESTRO
Cardholder name 
Card Number          
Expiry Date   /  
Start Date   /  
Issue No (Switch only)    
3-digit Security Code (last 3 digits found on the signature strip)  

Cardholder's address (if different to delivery address)

Name 
Address1 
Address2 
Town/City 
County 
Postcode 
print | close