personal information

Name(First & Last)

invoice address

Street address

Address line 2

Address line 3 (Town/city)

Address Line 4 (County)

Postcode / Zip

Country

Email address

Phone

mailing address (if different)

Street address

Address line 2

Address line 3 (Town/city)

Address line 4 (County)

Postcode / Zip

Country

payment method

Method

If you choose to pay by UK cheque, Bank Draft or Money Order please make it payable to:

Millennium Records Ltd. 6 Water Lane, Kentish Town Road, London NW1 8NZ ENGLAND

Once your Bank Draft or Money Order has been received, or your cheque has been cleared, your goods will be dispatched immediately. Please allow 7 - 10 days for processing and delivery.

This form is on a secure server, however if you prefer to phone-in your card details, please call:

From outside the UK

Phone: ++44 207 482 0272

From UK

Phone: 020 7482 0272

credit card information

Card type

Name of cardholder

Card number

Issue number/start date (Switch/Solo only)

Expiry date

Shipping