Trader Advertising Form

Web Site Advertising Order Form (Traders)

Note: All items with an asterisk * are required.

Please do not complete the form using capital letters

This order is processed on a secure server. We don't automatically debit your credit card when you send this request. Our operators check it for accuracy first. This avoids incorrect orders that require refunds.

* First Name	Initial *Title Mr Mrs Ms Miss Dr Capt Prof
* Last Name
Job Title
Company Name
*Address
Address
Address
* City/Town
* County, State or Prov.
* Postal Code / Zip
Country
Office Phone
* Home Phone
Mobile Phone
Office Fax
* Email Address
Web Site

I would like to apply for the following website advertising package;

Jester Package - Name of Business - FREE

Squires Package - Name, contact telephone number, email address. Photo or Logo - £20.00

(Please email us a photo or logo to info@mgel.com)

Knights Package - Name, contact telephone number, email address, website address. Photo or Logo. Information about the products that you sell (no more than 100 words) - £30.00

(Please email us a photo or logo to info@mgel.com)

For payment please provide either you credit card or debit card details:

Credit Card or Switch Number
Credit Card or Debit Card Type	VISA Master Card American Express Switch
Card Valid From Date (if paying by Switch)
Card Expires Date (all cards)
Card Issue Number (if paying by Switch)
Issuing Bank (all cards)
Amount I want deducted from my card
Cardholder's Name and Initials as they appear on the card
CVV2*:

*CVV2 is a 3-digit value at the end of your account number printed on the back of your credit card.

On American Express cards, CVV2 number consists of 3-4 digits located on the front of the card.

Any comments or requests?