ADVERTISERS ANNUAL ORDER FORM

(Please print out and send to us by fax or mail - details below)

Price: £285 incl P&P

   
Please send _____ copy(ies) to:
   
YOUR DETAILS: 

Name 

 ___________________________________________________________

Job Title

 ___________________________________________________________
Company ___________________________________________________________
Address ___________________________________________________________
City ___________________________________________________________
Postcode ___________________________________________________________
Country ___________________________________________________________
Tel ___________________________________________________________
Email ___________________________________________________________
Fax ___________________________________________________________
Reg charity no. (if applicable)
___________________________________________
   
PAYMENT DETAILS:
Cost is £285
Cheque I enclose a cheque (made payable to WBI Media & Entertainment)
Invoice Please send to me / my company (payment due within 30 days)
Credit Card Type ________________________
  Card Number ________________________
  Security Code
(3-digit number on back of card)		 ________________________
  Expiry Date ________________________
  Issue No. (maestro only) ________________________
Add cardholder's address if different to delivery address
   
Signature ___________________ Date ______________
   
FAX BACK TO: +44 (0)20 7549 8668
or mail to WBI Media & Entertainment, Paulton House, 8 Shepherdess Walk, London N1 7LB, United Kingdom