ASSOCIATION OF CLINICAL PATHOLOGISTS
189 Dyke Road
Hove
BN3 1TL
Paraphernalia Order Form
Item |
Price |
Quantity Required |
Total Cost |
| Hip Flask |
£16.50 |
|
|
| Alarm Clock |
£28.50 |
|
|
| Magnifying Glass |
£15.50 |
|
|
| Paperweight |
£24.50 |
|
|
| Association Crested Tie (Terylene/Crimplene) |
£5.50 |
|
|
| Association
Striped Tie (Silk) |
£17.00 |
|
|
| Golfing Umbrella |
£16.00 |
|
|
| Association
Crested Tie (Silk) Maroon or Navy |
£21.50 |
|
|
| Ladies Handbag Mirror |
£7.50 |
|
|
| 80th Anniversary Tie (Silk) |
£25.00 |
|
|
Name and address for delivery
(PLEASE PRINT)
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All prices are inclusive of VAT, postage and packing
Cheques should be made payable to "ACPath Ltd"
Payment can also be made by credit card - please complete the form below
Cardholder
Name: ..............................................................................................................................
Credit
Card (Visa
/ Mastercard only) Number: ............................................................................
Expiry date: ........................................
Security
Number (last 3 digits printed on reverse of the Card: .............................................
Cardholder address: .........................................................................................................................
..................................................................................................................................................................
Signature: ................................................... Total
Payment: ...........................................................
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