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Designer Wines Home Page

SECURE ORDER FORM KWW Security Team

YOUR NAME & ADDRESS

Your Name

Your Address

Street Town/City

County/State Country/Postcode

Telephone EMAIL ADDRESS

WRITE YOUR MESSAGE HERE

FIRST MESSAGE

1ST LINE OF MESSAGE (22 Large characters or 33 Small)

2nd LINE OF MESSAGE (22 Large characters or 33 Small)

WINE No BOTTLES

SEND THIS BOTTLE TO NAME

Address

Street Town/City County/State

Country/Postcode DELIVERY INSTRUCTIONS

DELIVERY (NORMAL 7-10WORKING DAYS )EXPRESS WITHIN 5 WORKING DAYS AN EXTRA £2.50 PER BOTTLE)

SECOND MESSAGE

1ST LINE OF MESSAGE (22 Large characters or 33 Small)

2nd LINE OF MESSAGE (22 Large characters or 33 Small)

WINE No BOTTLES

SEND THIS BOTTLE TO NAME

Address

Street Town/City County/State

Country/Postcode DELIVERY INSTRUCTIONS

DELIVERY (NORMAL 7-10WORKING DAYS )EXPRESS WITHIN 5 WORKING DAYS AN EXTRA £2.50 PER BOTTLE)

THIRD MESSAGE

1ST LINE OF MESSAGE (22 Large characters or 33 Small)

2nd LINE OF MESSAGE (22 Large characters or 33 Small)

WINE No BOTTLES

SEND THIS BOTTLE TO NAME

Address

Street Town/City County/State

Country/Postcode DELIVERY INSTRUCTIONS

DELIVERY (NORMAL 7-10WORKING DAYS )EXPRESS WITHIN 5 WORKING DAYS AN EXTRA £2.50 PER BOTTLE)

FORTH MESSAGE

1ST LINE OF MESSAGE (22 Large characters or 33 Small)

2nd LINE OF MESSAGE (22 Large characters or 33 Small)

WINE No BOTTLES

SEND THIS BOTTLE TO NAME

Address

Street Town/City County/State

Country/Postcode DELIVERY INSTRUCTIONS

DELIVERY (NORMAL 7-10WORKING DAYS )EXPRESS WITHIN 5 WORKING DAYS AN EXTRA £2.50 PER BOTTLE)

 

ORDER TOTAL

Please debit my Credit Card/Switch

Card No Expires Issue No(Switch)

Please ENTER 3 DIGIT SECURITY NUMBER ON FRONT OF CARD

(last three digits)

If paying by cheque make payable to Godwin & Godwin and send to Godwin & Godwin ,Basement,Kensington Chapel,London Road, Bath, N.E.Somerset BA1 6AW with printed copy of this order form,or you can fax this order form with your credit/debit card details to 01225337181

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