Mole Jazz
Auction Order Form


All bids are assumed to be in pounds sterling unless otherwise stated.

Please remember to complete the address panel and credit card details if applicable.

EC customers will have VAT added to bids at current rate: Export customers are VAT free.  
 

                                                 Address for parcel if different

NAME____________________________________________  NAME____________________________________________

ADDRESS_________________________________________  ADDRESS_________________________________________

________________________________________________  ________________________________________________

________________________________________________  ________________________________________________

COUNTRY_________________________________________  COUNTRY_________________________________________
 
 

   PLEASE CHARGE MY CREDIT/DEBIT CARD


       JCB        MASTERCARD       VISA       AMEX        DINERS

OTHER (State) SWITCH (UK) Issue No.
No.| | | | | | | | | | | | | | | | | | | | | |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Valid | | | | | Until | | | | | Signature From |___|___|___|___| |___|___|___|___| ___________________________

OVERSEAS CUSTOMERS ONLY - Post by            Surface              Air

                                                                                                                                                     (please circle as required)  
 

 ______________________________________________________________________________________________
|  Ref.Number |    Artist / Title       |   Label      |     Number       |    Bid     | Leave |
|             |                         |              |                  |            | Blank |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|
|             |                         |              |                  |            |       |
|             |                         |              |                  |            |       |
|_____________|_________________________|______________|__________________|____________|_______|