CREDIT CARD PAYMENT FORM

Please charge £150 (deposit) on ………………………… (date), and

Please charge £ …………………………… (balance of fees) on

…………………………… (date)

To my

VISA ( ) ACCESS ( ) MASTERCARD ( )

Card no. |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__| |__|

Expiry date |__| |__| |__| |__|

Cardholder’s address ……………………………………………………………………………………

…………………………………………………………………………………………

Name…………………………………… Signature ………………………………...