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					                                                                          ORDER FORM
                                                              Please complete this order form and send via:
                                                          Fax – 01258 455056       Email – sales@bristolmaid.com
                                           Post – Hospital Metalcraft Ltd, Blandford Heights, Blandford Forum, Dorset, DT11 7TG
 Company/Trust/Group Name:




Contact Name:______________________                                                 New Customer: YES / NO                        Account No. (if known):__________________

Contact Number:_____________________________                                                               Customer Email___________________________________

 Customer Address (BLOCK CAPITALS)                                                                         Invoice Address                (Please state if same as customer address)

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 Delivery Address (Please state if same as customer address)                                               Payment Options (A purchase order or unique reference is required
                                                                                                           for tracking purposes)
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 +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++   Purchase Order No:_____________________________
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                                                                                                             NEW ACCOUNTS ONLY
                                                                                                             PREFERRED PAYMENT METHOD:
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                                                                                                                         Credit Card
 +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++                 Cheque
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                                                                                                             Payment by account is offered after certain order
                                                                                                             criteria has been met.

 Item Code                           Qty.         Description                                                                                                     Unit Price                Total Price




                                                                                                                                                                            Total:


                                                               This order is subject to Hospital Metalcraft Ltd Terms & Conditions.
                                                         Please refer to www.bristolmaid.com/-terms.asp for current Terms & Conditions.

Name(Print):___________________________


Signature:____________________________                                               Position:______________________________                                       Date:__________________




Registered in England: Hospital Metalcraft Ltd. Registered office: Blandford Heights, Blandford Forum, Dorset, Dt11 7TG Co. Reg. No. 524837                                                  QC-72.01 Iss / Rev 1.0

				
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Description: Please complete this order form and send via