Spectrawax Lighting Printable Order Form
Fill out and return this form to:
Spectrawax Lighting, Unit One, Southpark, Peebles, Scotland EH45 9ED
Fax. 01721 729383 Phone:01721 723033

          First Name ____________________   Last Name _____________________

             Address ______________________________________________________

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                City ____________________________

         Postal Code __________________  Country __________________________

       Daytime Phone (___)________________  Email _________________________
  
     How did you find out about us? [_] Online  [_] Magazine   [_] Shops

                                    [_] Other _____________________________
                               

Name of Lampshade/Style
                                             Number                    Cost
                                                                      £/$/e
                                                                     Delete currencies
                                                                    not applicable
                                                                        

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                                                     Subtotal   £/$/e______.___   

          VAT and Carriage Inclusive                            £/$/e______.___   

                                                    

                                                        Total   £/$/e______.___
   

                                           
                 Make checks payable to:  Spectrawax Lighting                                                                        
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