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PERSONAL
DETAILS |
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* Name
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Tel
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* Address
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Email
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* Postcode
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DELIVERY
ADDRESS – If different from above |
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* Address
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* Postcode
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YOUR
KICKBIKE ORDER – Please list all items and prices |
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Item
Ordered |
Number
of Items |
Item
Price |
Total
Price |
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Delivery
Supplement |
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UK
Mainland - 24h delivery by TNT (24h not guaranteed to Highlands)
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£22.00
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Isle of Wight |
£34.00
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All other offshore islands & Northern Ireland |
£66.00
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TOTAL
COST (inc. delivery) |
£ |
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YOUR PAYMENT DETAILS - Tick relevant box &
complete necessary details |
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£ I enclose a cheque / postal order made payable to Vroom Scooters, OR |
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£ Please debit Total Cost of order from credit / debit card detailed below |
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CARD
DETAILS |
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Card
Number : |
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Expiry
Date : |
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Start
Date : |
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Issue
Number (Switch & Solo only) : |
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Security
Code (last 3 digits on signature strip)
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YOUR
SIGNATURE |
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Signature
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Date
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By signing and sending
this form to Kickbike UK you agree to our Terms & Conditions.
(See website or request
a copy from Kickbike UK).