PetCheckup

61 High Street

Tarvin

Chester CH3 8EE

Cheshire

 

                

 

Method of payment (please tick one)   _____ Cheque     _____ Credit Card    _____ Debit Card

 

Payment details:-   Creditcard.....Debitcard..... (tick)

 

Card No …………………………………………

 

Expiry Date …………………

 

Start Date (if applicable) ......……………………

 

Issue No (if applicable) …………………………

 

Security No (last 3 digits on back of card) ……..

 

Signature ………………………………………..

 

 

 

 

 

Name:........................................................................................

 

Address…………………………………………………….......

 

……………………………………………………....................

 

………………………...................Postcode …………………..

 

Tel ………………………………...Email.................................................................

 Please send order to above address

ORDER FORM

Please print out and send to PetCheckup

If sending a cheque

please make payable to:

Limestar

 

If you wish to pay by credit/debit card

over the telephone,

please phone 01829 741215