The Village Florist

82 School Road, Tilehurst, Reading, Berkshire Tel: (0118) 942 0136 Order Form VAT Reg. No. 570 0587 47

Please print off this form (File, Print) and use it to place your postal order. When you have finished, you may return to our Home page by using your 'Back' button (or View, Go To, Back).

Customer Information -	Delivery Information -
Name :	Name :
Address :	Address :
Phone no. :	Delivery phone no. :
	Delivery date :

Order -

Quantity	Description	Unit price	Amount

Total due

Payment Method -

We are happy to accept payment either by cheque, Switch or credit card. Please make cheques payable to "The Village Florist"; for Switch, please give the

Card no.

Issue no.

Start date

/

Expiry date

/

and for credit cards, please give the

Card no.

Expiry date

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Signature :

Date :