Mail or Fax Order

Mail or Fax in your order

Print out the following order form and either:

75 Coton Park Drive

Coton Meadows

Rugby

Warwickshire

CV23 0WL

Yes please, I would like you to design my coaching website for me!

Name: _________________________

Email: _________________________
(double check spelling as this is where your
web designer will contact you in the first instance)

Company (optional): _________________________

Address: _________________________

City: _________________________

State: _________

Country: _________________________

Zip: _________

Phone: ________________

PAYING BY CHECK/CHEQUE

Important: Please make your check/cheque payable to:

MANAGEMENT TRAINING & DEVELOPMENT LTD

(this is our holding company)

Make the check/cheque out for £175.08, US$325 or AUD$426

This includes Value Added Tax

PAYING BY CREDIT CARD

Credit Card (check one):

VISA
MasterCard
American Express
Discover

Card Number: _________________________

Security Code__________________________ (3 digit no)

Expiry Date: _________

Signature: _________________________

I authorize you to charge £175.08 to my credit card for the purchase of my website design.