ORDER FORM
Title:	First Name:		Last Name:
Address:
County/State:			Post/Zip Code:
Country:		Email Address:
Enquiries/Comments:
Type	Colour	Dioptre	Quantity	Price
.	.	.	.	.
.	.	.	.	.
.	.	.	.	.
.	.	.	.	.
Subtotal..........................................				.
Discount (see below)........................				.
Delivery (£3.50 UK, £6.50 non-UK)......				.
Amount Due.....................................				.
Discount: Order 2 or 3, get the lowest priced one for half price. Order 4 or 5, get the lowest priced two for half price each. Order 6, get the lowest priced three for half price each.
Please include payment with this order form payable to Online Reading Glasses. Send To: Online Reading Glasses, Unit 12, The Sycamores, Heatherwood Grove, Darlington, County Durham DL3 9PH, England.