ORDER FORM

SYCOM

Name
Address (Number and Street)
Town	Post Code/ZIP
Country	Telephone/Email

Description	Price Each	Quantity	Total
	£		£
	£		£
	£		£
	£		£
	£		£
	£		£
	£		£
	£		£
	£		£
Postage/Carriage Notes: Large items/Cables:- Please enquire (e-mail/Phone)	Total Price or Total carried to next page.		£
Order Value Postage Up to £5 £1.00 £5.01 to £10 £2.00 £10.01 to £15 £2.95 £15.01 + £3.50	Plus post and packing charges (final page)		£
	Grand Total (final page)		£

Paying By Credit Card: Sycom is able to accept payment by credit card for orders over £5, Mastercard - JCB - Visa only. Please fill in the section below on the last page of your order only. Payment must also be in £ sterling only. Please fill in the details below:-

Card Type	Please Tick	Expiry Date		Card Number. Signed....................................... Date ........../......./...........
Visa		/		Amount: £
Mastercard		/

  Send the completed form to:
  Sycom, PO Box 148, Leatherhead, Surrey KT22 9YW, UK