PERSONAL DETAILS Your name: Email address: Telephone number: Your name and address: Delivery name and address: type delivery address in here (if different from your 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? Please select Boy Girl Name of baby? Baby's birth date? Baby's birth weight? Personalised message? STORK ORDER 2 Baby Boy or Baby Girl? Please select Boy Girl Name of baby? Baby's birth date? Baby's birth weight? Personalised message? STORK ORDER 3 Baby Boy or Baby Girl? Please select Boy Girl Name of baby? Baby's birth date? Baby's birth weight? Personalised message? 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) alternatively you may fill in another order form Please indicate how we can expect payment Mastercard Visa Debit Cheque