Southern Medals Order Form

Southern Medals - Enquiry & Order Form

Please complete this form and we will deal with your enquiry as soon as possible.
Use your TAB key or mouse pointer to move between entry fields and then press the "Submit Form" button

E-mail
(required)

Name

Address

Town

County

Post Code

Country

Phone

Fax

Please reserve the specified items,
if available,
and despatch to the above address
when you receive my cheque.

The Universal Currency Converter: Should you wish to pay in your own currency please use
The Universal Currency Converter for the current exchange rate, please add the equivalent of Ł5.00 to cover our United Kingdom bank clearance charges.

*E-mail*	*(required)*
*Name*
*Address*
*Town*
*County*
*Post Code*
*Country*
*Phone*
*Fax*
Please reserve the specified items, if available, and despatch to the above address when you receive my cheque.