CLOSING DATE Wednesday 31 March 2010
e-mail info@simmonsgallery.co.uk Tel: 020 8989 8097 Intl.004420 8989 8097 NO FAX
FROM: Name:
_____________________________________________________________
Address:
_____________________________________________________________________
_________________________________________________Tel:
_____________________________
Email________________________________________________
(To
be completed by all bidders):
Date: ___________ Signature:
_______________________________________________
Please
complete if paying by Mastercard , Visa, Amex or Maestro (but
do not send card details by email)
Credit card & no: ___________________________________
Expiry
date: ______________________
Issue date.: (Maestro cards only)________
Security no. (Last 3 figures on back of
card) ______________________________
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Description |
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