Printable Private Treaty Order Form
             Please complete this form and return by post or fax to:

                                Brian Moorhouse
                 P.O. Box 105, Peterborough PE3 9TQ, England
                           Fax: +44 (0) 1733 262838

      Name:       .............................................................

      Address:    .............................................................

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      Telephone:  ........................  Fax:  .............................


      Cheque / check enclosed (circle appropriate)    Yes    No

      Credit Card Type (circle appropriate)    Visa    Mastercard    Amex


      Credit Card No:  ...............................  Expiry Date:  .........

      CVV Security Code  ........... (last 3 digits printed on signature strip 
      or the 4 digit number on the front of the card for American Express)


      Signature:  ................................  Date:  ....................


      Please quote stock numbers of the items required


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      Special Posting Instructions, etc.

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