www.ContaminatedLAND.co.uk

PLEASE PRINT THIS ORDER FORM OUT AND POST IT TO : -

'Bolux on a Disk'
www.ContaminatedLAND.co.uk
120 Grandison Road
London SW11 6LN England

I would like to order a copy of 'Bolux' for my personal use.
Please find enclosed with this order form (which is classed as 'an invitation to treat', i.e we can reserve the right to refuse to sell to you)

I confirm that the email address I am using is correct and belongs to me ! , should my email address change I will notify you of my new address, so that you can notify me when a new version of 'Bolux' hits the Web

Title (Mr / Ms / Mrs etc)..........................................................
First Name..............................................................................
Surname..................................................................................
Address..................................................................................
Address..................................................................................
Town/City........................................ Postcode.......................
Email......................................................................................
Signature...................................Dated (........./........./...200...)


send us an email to suggest improvements.

[Return to Top]

back to Home Page
URL: http://www.ContaminatedLAND.co.uk/send-now.htm
[Page created: 11th Nov 65, Last Update: 29th April 2000]
Copyright © 1996, Layla Resources Ltd, All Rights Reserved