Fax Transmission
To:italian-lighting-center.comFax Number:+44 (0) 29 2070 7334
SubjectCredit card details from for their order from italian-lighting-center.com
Please print this form from your browser, complete your credit card details in section 2 and sign and date in section 3 before faxing to us:
 
Section 1 - Your details:
Name:
Address:
,   
Tel:
Email:
 
Section 2 - Credit Card details:
Description:
Currency:
Amount:
Cardholders name (as it appears on card): 
Credit card number: 
Start date - if available: (mm/yy) / Expiry date: (mm/yy) / 
Security code: (3 digits) Issue number - Switch only: 
If you have any questions regarding the processing or storage of your credit card details please read our privacy policy or feel free to contact us.
 
Section 3 - Signature:
Cardholders signature: 
 
Date: 
PLEASE NOTE: Your order will not be processed or shipped until we have received your credit card details.
 
Thank you for making your purchase from italian-lighting-center.com.
Italian-Lighting-Centre.co.uk 74 Stanwell Road Penarth Vale Of Glamorgan CF64 3LQ United Kingdom Tel :029 2070 7037 Fax : 029 2070 7334