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Merchandise Mail Order FormTo purchase any of our fine products please print and carefully complete the following order form. Orders can be accepted by phone fax or post. Post the order form by regular mail to: GEM Motoring Assist Station Road,
Please send me:
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Please make your Cheque/I.M.O./Eurocheque payable to 'GEM Motoring Assist'
Or please debit my credit card:
CARDHOLDERS SIGNATURE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EXPIRY DATE: . . . . . . . . . . . . ./ . . . . . . . . . . . . . . . .
CARD NUMBER:
NAME: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Close Window |