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Order Form

Sirin Limited

Letters: Sirin Limited, we are relocating
 E-mail: tmg@sirin.com
  Phone/Fax: 020 7821 5911   International: +44 20 7821 5911

Thank you for your decision to order from Sirin Limited. We will try to despatch all orders, large or small, not later than next day, subject to availability in the stock. If you do not want to send your information over the Internet and would prefer another way to order, please use the information above.

  Fields marked by * are mandatory.
Your Name*:

  Your Company Name:

  Invoice Address (Must be the full Cardholder Statement Address, including postcode)*:

 

  Delivery Address (if different):

 

  Your E-mail Address*:

  Telephone Number*:

  Credit Card Number*:

Valid From:      Expiry Date*:

  Card Type*:

  Issue Number (if exists)*:

For American Express - four digit Batch code
(above embossed Card Number)*:

For Other Cards - Card Security Code - the last three digits
which appear on the signature strip on the back of your Card*:

VAT Number for organisations in the European Union
(for 0% VAT rate):

  Please enter the items you wish to order below:

(View the Price-List)

 

  Thank You!

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