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Dezire Lingerie Printable Order Form

Please fill in the form below, print it out and send it with payment to: Postal Orders, The Emporium Group, P.O. Box 3025, Southam, Warwickshire. CV47 1ZW.
Dezire Lingerie is a trading division of The Emporium Group. Please make cheques payable to 'The Emporium Group.'
If you wish to pay by credit card please enter your card details below and either fax to: 0844 856 0579 or send to the above address.

UK orders - Please allow 3 days for your cheque to clear, delivery will normally be 7-10 days from receipt of order. For international orders please allow 14-21 days from receipt of order.


Item
Qty
Item Code
(e.g. X1234)
Colour
Size
Description
(e.g. Lace Babydoll)
Cost Each
Cost Total
(Qty x Cost Each)
1
             
2
             
3
             
4
             
5
             
6
             
7
             
8
             
9
             
          Carriage within UK £3.60  
          Carriage within EU £6.00  
          Carriage Outside UK And EU £9.00  
            TOTAL
COST
 

If paying by credit card, please enter details below:

Type Of Card:  
Card Number:
 
Start Date:  
Expiry Date:  
Security Code: (Last 3 digits on reverse of card)
 
Name On Card:  
Address Of Cardholder:
(If different from below)
 


Please enter your contact details below:

Name:  
Delivery Address:  
Phone:  
Email: (Optional)  

 

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