Please complete all fields
We will also need your credit card details.
You can download the credit card authorisation form (pdf version or word version), complete it and either print it and fax it to 0131 315 4840
or email it to email@example.com. If emailing the form please send your credit card security number in a separate email.
Alternatively you can telephone us on 0131 315 2464.
Please tick this box to confirm that you have read the payment procedure above
Farside Africa 16 Dean Park Mews Edinburgh EH4 1ED United Kingdom
tel: 0131 315 2464 email: firstname.lastname@example.org