WALKHIGH MOUNTAINEERING ORDER FORM - FOR FAX AND POSTAL ORDERING

Please complete and send to             or FAX to

Walkhigh Mountaineering			Walkhigh Mountaineering
10 Rainsbrook Close                     UK: 01926 353476
Southam					INT: +44 1926 353476
Warwickshire
CV47 1gl

YOUR DETAILS  (* Required information)
------------

Your Name*	________________________________________________

Your Address*:   ___________  Telephone* _______________________

____________________________  Mobile     _______________________

____________________________  email      _______________________

____________________________  Postcode   _______________________


PAYMENT DETAILS
---------------
Postal Order / Cheque (crossed 'AC Payee')
  Cheques and Postal Orders payable to "Walkhigh Mountaineering" 

Credit card / Debit Card
  Note: Delivery address must be same as billing address of card.
  TYPE: VISA[ ] VISA DEBIT [ ] MASTERCARD[ ] UK-MAESTRO[ ] 
	SOLO[ ] ELECTRON[ ] AMEX[ ] JCB[ ]

  CREDIT/DEBIT CARD NUMBER _______________________________________

  VALID FROM    __________   VALID UNTIL  _________ 

  ISSUE NUMBER  __________   AUTH NUMBER*  _________ 

*last three digits on signature strip or 4 digits on Amex cards

  ACCOUNT NAME  ____________________________________ (as per card)

  I Authorise Walkhigh Mountaineering to debit my account with the 

  sum of £_____________      Signed _______________________________





ORDER DETAILS   (continue on additional sheet(s) if necessary)
-------------

ITEM  QTY    DESCRIPTION     SIZE/COLOUR      PRICE          TOTAL
                                              EACH
----  ---    -----------     -----------      -----          -----

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4.________________________________________________________________

5.________________________________________________________________

6.________________________________________________________________

7.________________________________________________________________

8.________________________________________________________________
 
9.________________________________________________________________

10._______________________________________________________________

11._______________________________________________________________

12._______________________________________________________________

13._______________________________________________________________

14._______________________________________________________________
 
15._______________________________________________________________

16._______________________________________________________________

                                  A. TOTAL PRICE       £

                    (see website) B. DELIVERY          £  
      
                                  C. CREDIT NOTES      £ -
                                                       ___________

                         A + B - C   TOTAL ORDER VALUE £