21st Century Beads Order Form

Please provide the following delivery and contact information:

Name
Title
Street address
Address (cont.)
City
County/State
Postal/Zip code
Country
Work Phone
Home Phone
Mobile
FAX
E-mail

Date of order:

-- dd/mm/yy

If you have ordered before or have a reference number on your order form (LON), please state it here:

Please list your order stating quantity required, finish and size (if applicable) and page number if ordering from our catalogue; if there are not enough lines for all the items you wish to order, please feel free to submit two or more forms - just put in the Comments box at the end that your order is on more than one form. Please avoid mixing Wholesale and Retail on the same order form - just submit one for your Wholesale order and another one for your Retail order. Thank you!

QTY PG FINISH SIZE DESCRIPTION

Please indicate method of payment:



Card number:

Expiry date:

Issue Number/Valid From date of your card (if given):

Security Code (last three digits printed on signature strip after card number):

If the cardholder's address is different from the delivery address, please enter cardholder's postcode and house number:

UK Customers only - would you like additional Insurance on your order? (£1.00 extra in addition to P&P):

Yes No

Special Instructions/Comments :-

  

Thank you for your order which will be processed as quickly as possible. Please ensure that you have completed this form correctly, particularly the contact details which will enable us to get in touch with you if necessary.
Our Terms of Trading and Postage and Packing charges are set out in 21st Century Beads from Earring Things catalogue in full, and in abbreviated form on the 21st Century Beads - Earring Things website at www.beadmaster.com

Copyright 21st Century Beads - Earring Things - The Bead Merchant 1999, 2000, 2001, 2002, 2003, 2004, 2005 and 2006.
No reproduction of any part of 21st Century Beads from Earring Things/Earring Things - The Bead Merchant catalogue or Beadmaster website at www.beadmaster.com may be made without prior permission in writing.
Last revised: February 06, 2008