My Name:                                  
House Name:                              
House No. and Street Name:        
Village/Town/County: 
Postcode:                                                           
My landline tel. no. in case of problems is:     
Name of recipient:         
Value for voucher (Min. £50):

Please send the Voucher, not to me, but direct to the recipient's address below (if required):

with this message:

Either: I enclose a cheque payable to P.Roberts for the amount shown. I understand that there will be a delay while my cheque clears (up to ten days)

Or: For transactions using M/C, Visa, I understand you add an additional 5% to cover the charges and costs - I have filled in my credit card details below.

Card Number:     

         

Expiry Date:           Security No (on signature strip)

DISTINCTLY DIFFERENT, 4 MASONS LANE, BRADFORD ON AVON, BA15 1QN, UK.   Fax. 01225 866648

If you have any problems, phone us - Tel. 01225 866842.
To order a Voucher from outside the UK or to be sent outside the UK
telephone 44 1225 866842 or E-Mail voucher@distinctlydifferent.co.uk

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