Scentia - Organic Therapy

Please complete this form with the required order and delivery details then :-

EITHER use the Print Form button to print and post to me, OR use the Submit Order button to email your order.
(* P & P and Delivery details)


                      Sherron Holder-Culver
                      Scentia
                      123 Any Road
                      Anytown
                      County PST C0DE
                      United Kingdom

Phone: 01234 567890
Website: http://www.scentia.co.uk
Email: enquiries@scentia.co.uk

ORDER DETAILS

	Please enter Price from the Product Description selected.
	Product Category	Product Description	Price	Quantity	Sub-Total










		Total Goods
		Add Post & Packing *
Preferred payment method :			for : TOTAL £

Cheques MUST be drawn on a UK bank. PO's MUST be British Postal Orders
Please make cheques and postal orders payable to Sherron Holder-Culver
putting card number and expiry date on reverse
Please DO NOT send cash as Scentia cannot be held liable for any resulting loss.

DELIVERY DETAILS


Title	First Name	Last Name
	Address 1	Address 2
	Town / City	State
	Country	Post / Zip Code

* UK postage and packing per item £ 0.50 p. Overseas postage and packing per item £ 1.50 p.
Please allow 28 days for delivery.
Goods will be dispatched within 24 hours of cheque clearance / immediately on receipt of postal orders.