Untitled Document

ASSERT Order Form

Quantity Total
DVD's - £2 each

plus postage at £1 each UK, £2 each Europe, £3 Other

Order Total:

Name: ......................................................................................................

Address: ......................................................................................................

......................................................................................................

......................................................................................................

Postcode: ......................................................................................................

Please send your completed order to:

ASSERT, Freepost, PO Box 4962, Nuneaton, CV11 9FD

Please make cheques payable to ASSERT

	Quantity	Total
DVD's - £2 each
plus postage at £1 each UK, £2 each Europe, £3 Other

	Order Total:

Name:	......................................................................................................

Address:	......................................................................................................

	......................................................................................................

	......................................................................................................

Postcode:	......................................................................................................