Please print this form and complete the following in BLOCK LETTERS:

Name (Mr/Mrs/Ms/Miss) __________________________________________________

Address _______________________________________________________________

______________________________________________________________________

Postcode/Zip ____________________________ Country _________________________

Telephone ______________________ Email ___________________________________

EITHER I enclose my cheque/sterling draft for __________ British pounds
Cheques/sterling drafts should be made payable to M Grey.

OR Please debit my Visa/Mastercard to the value of __________ British pounds

Card number ________________________________ Expiry date __________________
PLEASE CHECK THIS NUMBER CAREFULLY. WE ARE CHARGED IF IT IS WRONG.

Name on the card _________________________________ Security Code____________
THE LAST THREE DIGITS ON THE SIGNATURE STRIP ON THE BACK OF THE CARD.

Cardholder's signature: ____________________________ Date ___________________

Please return by post to: Workshop on the Web, 19 Merriefield Avenue,
Broadstone, Dorset, BH18 8DA, UK,
or by fax: If in Great Britain, 01202 897211, if outside Great Britain,
use the standard dialing code for international calls, followed by 44 1202 897211.