RETURN TO: Andy Rowlett, External Programme

Room STG13, Stewart House

32 Russel Square, LONDON, WC1B 5BN
TEL/FAX: +44(0)20 7862 8323 / 8329
E-MAIL andrew.rowlett@lon.ac.uk

Publications Order Form ORDER NUMBER (office use only)

If you wish to make a purchase you should:

1. Enter the title of the publication and its price in the box adjoining in the table below.
2. Complete the table below with the quantities required and the costs payable.
3. Fill out the rest of the form with payment details, your student number, and your postal address.
4. Enclose your payment and return or fax the form to the above address.
5. Guides are not available for collection, so you must provide delivery details.
Note: Your student number and College MUST be filled in.

Title Price Each (GBP) Quantity Total (GBP)

Total (GBP)

Note: Cheques or Postal Orders should be made payable to:

UNIVERSITY OF LONDON and crossed Nat West Bank a/c payee.
Banker's Draft should be made payable to:
UNIVERSITY OF LONDON
c/o Nat West PLC, Tavistock Square, London WC1H 9JA
a/c 60-80-07 36403385

I enclose a: Cheque * (please tick as appropriate)

Sterling Bankers Draft
Postal Order

Credit Card Payment to the value of: GBP

Student Number: Name:

College: e.g. Birkbeck or External Programme

Address for delivery:

Country:
Post Code:

Signed:__________________ Date:____________
 University of London Order Number:
External Programme Office Use Only

Credit Card Payment Form

Please debit my card for the following amount (GBP): *

Visa Mastercard No debit or cash cards are accepted.

Card type: * (please tick as appropriate)

Name of Issuing Bank: *

dd/yy
Card expiry date: *

Card number:

Cardholders name and initials (as printed on the card): *

Cardholders billing address: *

Signature: *

dd/mm/yyyy
Date: *

*ALL fields must be correctly filled in