ORDER FORM

for Centurions merchandise

Order form

Please (1) print form, (2) fill in and then (3)  send to: Ian Statter, 78 Keston Avenue, Old Coulsdon CR5 1HN  - with your cheque

email Ian.Statter1@talktalk.net
for further details

 Please make cheques payable to The Centurions.

      

Item

 

Colour

Size

Number

Price

P&P

Total value

Polo shirt

 

 

£12.50

£1.00

 

Fleece

Navy

 

£15.00

£2.00

 

Tie

Navy

 

 

£6.00

free

 

Badge

-

-

 

£5.00

free

 

Handbook

-

-

 

free

 

 

Donation

-

-

 

 

 

 

TOTAL

 

 

 

 

 

 

Your name and address: 

Name:

Address:

 

 

Postcode:

Tel. no.                                                                        email:

Centurion number:

  

           

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