Respect Phoneline publicity material order form

Order details

	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

Address

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
Should be Empty: