Respect Phoneline publicity material order form
Order details
Rows
Quantity
Cost
Respect Phoneline leaflet for clients, 5p per item
Respect Phoneline A4 display poster, 10p per item
Respect Phoneline leaflet for frontline workers,
"Choose to stop", 32-page booklet for heterosexual male perpetrators, £2 per copy
Choose to stop, 32-page booklet for gay/bi male perpetrators, £2 per copy
Booklet for heterosexual women using violence, £2 per copy
Subtotal
Plus 20% VAT
GRAND TOTAL
Name of person submitting order
First Name
Last Name
E-mail
Organisation name
Address
Street Address
Street Address Line 2
City
County
Postcode
Payment details (orders are dispatched after payment has been received)
Bank transfer -Acc. name: Respect, sortcode: 405240, acc. number: 00019209
PayPal, info@respect.uk.net
Credit/Debit Card (Visa, Maestro or Master Card) over the phone-0207549 0578
Cheque payable to Respect
Invoice
Invoice contact name and contact information if different from above:
Are you a Local Authority/Government/Statutory body? A purchase order is required if Yes.
Yes
No
Purchase order number
Submit
Should be Empty: