The Brylcreem Boys - VHS Video
Credit Card Order Form
This is not an online form. To be posted or faxed. Please print and complete.
I wish to order ___ copies at ONLY 9.99 (PAL) £16.99 (NTSC) each, including shipping and handling.
Shipping Details
Zip/Post Code  
Fax number  
Email address  
Credit Card Details
Total amount I will be paying _______________  
Credit card (please tick) Visa ___ | Mastercard ___ | JCB___ | Switch ___ (Switch issue no. _________________)
Card number   |    |    |    |    |-|    |    |    |    |-|    |    |    |    |-|    |    |    |    |
Card expiry date (mm/yy) ____/____
Cardholder full name  
Cardholder billing address(if different from)  
Cardholder billing address (cont.)  
Cardholder ZIP / Post Code  
Cardholder country  
Cardholder's signature  

this order form to:
FUTURE VIDEO SERVICES Ltd, 2 Endeavour Way, Durnsford Road Industrial Estate, London SW19 8LH, UK
or Fax on + 44 (0)20 89462568

IMPORTANT NOTE: The videos are available in different formats according to where they are viewed. Tell us in which country your video(s) will be viewed: ____________________

If you have time, please show how you found us: | Via our listing in a search engine or directory ___ | Via a friend, relative or colleague ___ | Via a newsgroup___ |

You are purchasing this tape in sterling. As exchange rates go up as well as down and this can occur on a daily basis, Guerilla Films Limited cannot be held liable for any change between the day you buy the video and the day your bank or credit card company debit your account. Please keep a copy of this form as your receipt.
Thank you for your order. For further information contact guerilla films

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