My Shipping Details (Please print clearly)
Title: __________ Full Name: ______________________________________________
Address: ________________________________________________________________
________________________________________________________________________
Postcode: __________________________________________
Telephone: _________________________________________
Email: _____________________________________________
| Item | Price | Quantity | Item Total |
| Postage: (up to £24 = £1.25, £24-£75 = £2.50, above £75 = free | |||
| TOTAL: |
To pay by Credit / Debit card for fast delivery call 0845 123 2631 or order online at www.stateofhypnosis.com
Card Number: ____________________________________________________________
Card Type: • __ Visa • __ Mastercard • __ Switch/Maestro • __ Solo • __ JCB
Name on card: ________________________________ Signature: __________________
Security code (last 3 digits printed on signature strip) _____________________________
Expires: ___________ Valid From: ____________ Issue No (Switch): ________
Or enclose a cheque / postal order for the full amount.
Please return this form using by Freepost (no stamp required) to Freepost Plus RLSR-ZUYL-RBES, Phoenix Transformational Therapy, 114 Melrose Avenue, Bletchley, Bucks, Milton Keynes, MK3 6PP