Request for Purchasing Service

Information About You

Your name:

Your email address:

Your postal address (no apostrophes please):

Name of your mission agency (alphabetic characters only, please):

Email address of your mission:

Postal address of your mission (no apostrophes please):

Information about what you need

What is the name of your chosen item?

Please give the model, size, colour or any other essential details that describe it:

Maximum price to pay (in pounds sterling): £

(Please enter numbers only or zero to indicate that you have no limit in view.)

Please give details of any potential sources that you can recommend:

(If you have no suggestions, please just enter "None".

How would you like the item sent to you?

What arrangements will you make for payment?

(This will be to cover the purchase and shipping costs.)

Please type the characters displayed on the left into the box on the right. All alphabetical characters are shown in uppercase but you may type them as lowercase. The number zero is indicated with a diagonal line whilst the letter O is clear inside.

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