Please print this order form and enclose it with your check.
Our address is shown at the foot of this and every page
All Prices Include Airmail Postage
| Quantity | Monarch | Type | Price $ | Amount $ |
| Elizabeth II | Second Head | $500 | ||
| Elizabeth II | First Head | $500 | ||
| Elizabeth II | Year 2000-2009 | $500 | ||
| George V | First Head | $510 | ||
| George V | Small Head | $510 | ||
| Edward VII | $510 | |||
| Victoria | Old Head | $515 | ||
| Victoria | Jubilee Head | $520 | ||
| Victoria | Young Head Saint George | $530 | ||
| Victoria | Young Head Shield | $580 | ||
| Any Above | Your Choice Of Date Extra | $20 | ||
| Our Choice | Special Offer | $490 | ||
| Others | Extras | |||
| Box | White Leatherette | $3 | ||
| Aimail Postage & Packing | At Buyers Risk...or... | $10 | ||
| Airmail Postage & Packing | ...Fully Insured | $20 | ||
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| $ | |||