Wild Tiles Purchase Form


Please print out this page, then fill-in and return the form


(Printer friendly)

Order Form


Item Description
Reference Number
Quantity
Price
Total
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Order Total ..................


Name................................................................................................................................

Address.............................................................................................................................

..........................................................................................................................................

..........................................................................................................................................

E-mail address (optional)...................................................................................................

Telephone number (optional)............................................................................................

I have enclosed the sum of .................payable to Jan Kilpatrick. Please send me confirmation of my purchases and dispatch to the address above.

I found out about Wild Tiles through.....................................................................................


Send to:

Jan Kilpatrick, Wild Tiles, Cul Mor, Elphin,
Near Ullapool, Sutherland, IV27 4HH.
Tel : 01854 666279
Email : jan@wildtiles.co.uk

www.wildtiles.co.uk


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