Please print this form out to order and make all payments out to East Anglia Wing Chun Athletic.

Post this order form to

Sifu Brian Desir
45 Stockingstone Rd
Luton
Bedfordshire
LU2 7ND
Phone 01582 514246/Mobile 07798807567

Please print clearly.

Name:___________________ Address:________________________________________________ Town/City:____________________Post code:_________________ Contact number:__________________email:__________________

Description of Item_1:________________________Qty:______________ Item_2:________________________Qty:______________ Item_3:________________________Qty:______________ Item_4:________________________Qty:______________

Pay by Cheque or postal order________________________
Including Postage and packing: £3.00
Total cost £_____
 
Would you like your copy of The Complete Wing Chun System signed and dated? YES/NO
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