Brittens MUSIC - Secure Order Form

Brittens MUSIC Eastbourne
24 Pevensey Road : Eastbourne BN21 3HP : England
Tel: +44 (0) 1323 732553 : Fax: +44 (0) 1323 417455
E-mail: eastbourne@brittensmusic.co.uk
VAT Reg. No. GB 347 2213 73

Secure Enquiry/Order Form

Use this page to order electronically or to make an enquiry.

Any data entered on this form will be used solely for the purpose
of placing an order or making an enquiry with Brittens MUSIC
and will not be passed to any other party.

We do not charge credit cards until goods are dispatched.

Name
Street Address
Town
Post/Zip Code, including state
Country
E-mail Address
Repeat E-mail Address
Telephone

If placing a first order:

Credit Card Type:	Mastercard/Visa American Express Switch/Solo
Credit Card Number:
Expiry Date	Start Date	Issue No. (for UK Switch & Solo cards only)
Card Security Code	(this is the last 3 digits printed on, or just beneath, the card signature strip - either after the full card number or after the last four digits of the card number)
Please note that Discover, Electron and Maestro cards are NOT accepted for mail order transactions by UK banks.

Please write your order or enquiry here.
We are always happy to quote firm prices before processing any order.
If you need hard copy of your order or enquiry, please print out this form before you 'continue'.

Please check your entries on this form (making sure that you have entered your e-mail address correctly) and press the 'continue' button to finalise your order or enquiry.

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