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To use our Mail Order Facility please print off the form
on this page and post or fax to the address given below. |
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LAKESLATE
The Broughton Craft Shop, Griffin St., Broughton-in-Furness,
CUMBRIA, LA20 6HH.
TEL: 01229 716413 E-MAIL:
enquiries@lakeslate.co.uk
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| Title: |
Surname: |
M.I.: |
| Address: |
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| County: |
Postcode: |
| Daytime Telephone: |
| E-mail address: |
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| Credit Card Number ( Visa & Mastercard only )
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| Name on card: |
Expiry Date: |
| Signature: |
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| Recipient Details ( if different from above ): |
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| Title: |
Surname: |
M.I.: |
| Address: |
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| County: |
Postcode: |
| Daytime Telephone: |
| E-mail address: |
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Price |
Total |
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Cheques (Made payable to LAKESLATE)
Please write your address & card number
on the reverse. |
SubTotal |
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| P&P |
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| Total |
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