Friends of Locomotive 4930 Hagley Hal 4930 Home

'The Severn Forty Nine' Order Form

(right click and select "print")

Please use BLOCK CAPITALS
Please allow 21 days for delivery

Name:___________________________________________________________________________

Address:_________________________________________________________________________

_____________________________________________________   Post Code:_________________

Contact Telephone Number:_______________________________    Date:______________________

No of unframed prints required:___________ @ £20.00 inc £2.00 p&p UK

No of framed prints required:___________ @ £49.30 plus £25.00 p&p UK

Donation at own discretion: £______________        Total Amount Payable: £_________________

Cheques payable to: "FRIENDS OF LOCOMOTIVE 4930 HAGLEY HALL" OR by Bank Transfer to Sort Code 20-53-22, Account No. 20160210, stating surname as reference.

Post to :-
Friends of Locomotive 4930 Hagley Hall
Cherryholme
Pound Bank
Far Forest
Kidderminster
Worcs
DY14 9RE