O r d e r   F o r m

 

 

                                   
Your name…………………………………………………………………………..

 

 

Your address ……………………………………………………………………….

 

       

Town:………………………………………………………………………………

 

 

County:……………………………………Post code ………………..……………

 

Contact telephone number ……………………………………………………….
 

 

Email address ……………………………………………………………………….

 

 

Please supply ……   copies of

                                                                         

The Parrot Bag @ £10.50 incl. UK P&P                          £...........


My Lover's Birds @ £7.00 incl. UK P&P                         £...........

Corncockle @ £7.50 incl. UK P&P                                  £...........

 

 

Ten Poems for Performance @ £6.50 incl. UK P&P       £...........

 

                                                

  Holding The Line @ £10.50 incl. UK P&P                     £...........


                                                                                                                 

                                                                                            Total     £_______

 

I enclose a cheque/postal order in sterling to Diana Mitchener for £_______

 

Address: 64 Rosehill, Billingshurst, West Sussex. RH14 9QQ
 

Tel: 01403 783456                                   Email: diana.mitchener@gmail.com

Or pay using your credit/debit card or PayPal account here.