Stork order fax/postal form
After completing this form either:
(1) Fax to +(44) 08717 150310
(2) Post to Rob and Sue Roebuck, STORK AND CRADLE, The Cottage, Normanby-le-Wold, Market Rasen, Lincoln, LN7 6SS, ENGLAND
If posting cheques made payable to Rob and Sue Roebuck can also be sent
PERSONAL DETAILS
Your name:
Email address:
Telephone number:
Your name and address:
Delivery name and address:
How did you hear about us?	Please select Existing customer Craft fair Word of mouth Internet Advertising Other
STORK ORDER 1
Baby Boy or Baby Girl?	Boy Girl ---------------------------------------------------------------------------------------
Name of baby?
Baby's birth date?
Baby's birth weight?
Personalised message? (e.g. with love from Ella)
STORK ORDER 2
Baby Boy or Baby Girl?	Boy Girl ---------------------------------------------------------------------------------------
Name of baby?
Baby's birth date?
Baby's birth weight?
Personalised message? (e.g. with love from Hettie)
STORK ORDER 3
Baby Boy or Baby Girl?	Boy Girl ---------------------------------------------------------------------------------------
Name of baby?
Baby's birth date?
Baby's birth weight?
Personalised message? (e.g. with love from Kiki)
PLEASE INDICATE THE COST OF THE ORDER (price includes postage & packing)
Prices subject to change: Please use the latest form from the website. Thank you 01/04/07
UK prices (£13.25 per stork)	Do not charge UK price 1 stork = £13.25 2 storks = £26.50 3 storks = £39.75 --------------------------------------------
EU prices (£13.75 per stork)	Do not charge EU price 1 stork = £13.75 2 storks = £27.50 3 storks = £41.25 --------------------------------------------
Rest of the world prices (£14.50 per stork)	Do not charge ROW price 1 stork = £14.50 2 storks = £29.00 3 storks = £43.50 --------------------------------------------
IF YOU WISH TO ORDER FURTHER STORKS PLEASE INCLUDE DETAILS HERE
Further order details (please remember to also include the cost of any extra items)
PAYMENT DETAILS
Payment method	Mastercard Visa Debit Cheque
Cardholders name
Credit card number
Expiry date
Security Code (Last 3 digits on reverse of card)
Cardholders signiture
Rob and Sue Roebuck, STORK AND CRADLE, The Cottage, Normanby-le-Wold, Market Rasen, Lincoln, LN7 6SS, ENGLAND Email: robandsueroebuck@btinternet.com    Tel: +44 (0)1673 828410 Fax: +(44) 08717 150310
	design - CJR Consultancy