Agranova Order Form

Agranova Order Form

Please refer to the Price List for current pricing.

Use this form to send your order by fax or e-mail :
Agranova
tel: +44 1689 600 501
fax: +44 1689 897 786
e-mail: agranova@compuserve.com

Order Date : Please write clearly - use BLOCK CAPITALS !

Title/Name :

Company :

Address :

City :

Postcode/Zip : Country :

Tel :

Fax :

e-mail :

Code

Description
Qty. Unit
Price Total

Grand Total :

Cheque enclosed

Bill me later

<< Select method of payment

Mailing is free for all pre-paid orders. Shipping and handling costs will be added to the invoice for all billed and proforma orders.

GBP cheques must be drawn on a UK bank and made payable to Agranova.