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__ __ __ (last three digits on the signature strip on the back of your credit card) |
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BLISSBOX.COM ORDER
FORM
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Product Name |
VHS |
DVD |
Description (large, medium)
if applicable |
Quantity |
Price |
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Insure your parcels delivery for just £ 0.79 |
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Total value |
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O
I enclose a cheque payable to Black Dog Ltd
(Please print your cheque guarantee card number and expiry date on the back
of the cheque)
O I enclose a crossed postal order payable to Black Dog Ltd
O
I wish to pay by Credit/Debit Card. Please charge my
Visa / Mastercard Card
(please delete as appropriate)
please note these are the only cards we accept
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All information you provide will be treated in the strictest confidence
| Name | |
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| Address | |
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| Postcode | Phone No. | ||
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Signature | ||
| O I am over 18 and I accept that these items are sexually explicit | Date of Birth |
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Ordering Online: |
www.blissbox.com |
Orders take between 7-28 days depending on payment method
O Please tick if you would not like to receive further information from Blissbox.