Order Form for the Book 'Luppitt, Parish, Church, and People'

To:

Luppitt History Book,
14 Pixey Place,
OXFORD.
Oxfordshire
OX2 8BB

Please can you send _____ copy(ies)  of the book about the history of Luppitt 
titled 'Luppitt, Parish, Church, and People'.

My address is:

Name:       	____________________

Address 1:   	____________________

Address 2:   	____________________

Town:          	____________________

County:        	____________________     

Postcode      	____________________

Country:     	____________________

Date:		____________________

Email address:	____________________
(This is optional, it's so I can email to confirm your order has been received)


I enclose payment of £7.50 per copy plus £3.00 per copy Post & Packing. 

This payment is in the form of a UK Sterling Cheque/Postal Order to
the value of    ______  MADE PAYABLE TO: ' LUPPITT LOCAL HISTORY GROUP'

I understand that the money will be drawn before the goods are despatched, and 
delivery may take up to 28 days (but usually takes much less).

If you wish to order from a country other than the UK, please contact me by post 
for details, or email directly for more information

Please put any other comments or questions in the space below: