Roger Clark Motorsport accepts all types of major credit cards.
Payment
Please fill in all required information clearly, in pen
on the lines provided using capital letters.
Please make sure that if you contact us by telephone,
you have the following information ready.
If you wish to pay by credit / debit or visa / mastercard
or American Express, then please complete the following
(if it appears on your card):
Name of credit/debit card holder: __________________________________________________________
Address that appears on the credit card holder's
statement (billing address):
House No. or Name: ____________________________________________
Road/Street Name: ____________________________________________
Town/City: ____________________________________________________
County/State: _________________________________________________
Country: ______________________________________________________
Postal Code/Zip Code: __________________________
Full credit card number:__________________________________
'Valid from' date: ____ / ____
eg: 08 / 04
'Valid to' (expiry) date: ____ / ____
eg: 02 / 02
Security code: ____ ____ ____
ie: (last 3 digits located on the signature strip on the back of your card):
If you are paying by switch card, then your card
may have an Issue number, if so then please enter it here:
________
Please make sure that you provide
a telephone contact number, so that if problems are experienced
in processing your credit card payment, we are able to
contact you and minimise any delay in despatching your
order.
Telephone number: (including country code and area code)
Country Code: ________
eg: +44
Local Area Code: ___________
eg: 01455
Your Telephone Number: _____________________
eg: 828610
Your Order
Print out and fill in for fax orders. Our FAX number is: +44 (0) 1455 828620.
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