Western Isles Mod 2005 | Merchandise order form

Mòd 2005 Merchandise Order Form

Name
Delivery Address
Postcode
Phone number
email

	*Price*	*Number*	*Total*
*Fudge - Assorted*	£4
*Fudge – Full Cream*	£4
*Fudge - Whisky*	£4
*Mug*	£5
*Pens state colour(s):*	£1
*Sub - total*
*Delivery 15%*
*TOTAL*

Please print a copy, complete and return with payment to :

Mòd nan Eilean Siar 2005
An Comunn Gaidhealach
Perceval Square
Stornoway
HS1 2DD

Please make cheques payable to Mòd nan Eilean Siar

Còraichean © 2005 Mòd nan Eilean Siar.