LEO RECORDS

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Credit Card Order Form

Please use the following form for your orders: Fill in the fields of the form, print it, and post to Leo Records, 16 Woodland Avenue, Kingskerswell, Newton Abbot TQ12 5BB, United Kingdom

1. Please provide the following ordering information:

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

Quant.	CD - Artist name: title, price/GBP

SubTotal per Order, � (British Pounds)
Post & Packaging, �	2.0
Total per Order, �

2. Please provide the following shipping/
contact information (*-required):

First and Last name*

Street address*

Street address (Cont'd.)

City*

State/Province

Zip/Postal code*

Country*

Home Phone

FAX

E-mail*

3. Please provide the following Credit Card information:

Credit card*

Cardholder name*

Card number*

Expiration date (month/year)* (format MM/YYYY)

Purchase Order Date*

Cardholder Signature* _____________________________

4. Print the form
and post to

Leo Records,
16 Woodland Avenue
Kingskerswell
Newton Abbot TQ12 5BB
UNITED KINGDOM

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