Millers Trading Post Order Form

For security reasons simply fill out this order form, print out and fax to the following number. We will be getting on-line secure ordering very shortly: Fax: +44 (0)161 626 8734.
Alternatively you may wish to place your order by telephone:
Tel: +44 (0)161 624 9686 Mon - Saturday 9.00am - 5.00pm (GMT)

Please provide the following contact information:

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

Please provide the following ordering information:

QTY	DESCRIPTION	AMOUNT INC P&P.




	TOTAL AMOUNT INC VAT.

	BILLING
Credit card
Cardholder name
Card number
Expiration date

	SHIPPING
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country

Enter todays date.. :

-- mm/dd/yy