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Siobhan Wear Fax Order Form
Please print out this form, then fill in your details an fax it to us, thank you for your custom
Siobhan Wear House
#13 Connolly Street,
Bandon,
Co. Cork,
Ireland.

From Ireland  Tel : 023-8843993 or 021-4378255
From Ireland  FAX : 023 - 54040

From outside Ireland  Tel: +353-23-8843993 or  +353-21-4378255
From outside Ireland  Fax: +353 - 23 - 8854040

Item name: ________________________________________________
Item number: ________________________________________________
Fabric:    ________________________________________________
Fabric colour:  ________________________________________________
Lining: ________________________________________________
Lining Colour: ________________________________________________
Full Height (J) : ________________________
Dress Size (I): ______________________ (women only) 
Bust/Chest Size (E/F): _____________________
Desired finished
length of garment
in inches
or centemetres (H) :		 ______________________ (knee/calf/ankle?)_
Desired finished
length of sleeve
in inches
or centemetres (K) :		 ______________________ (knee/calf/ankle?) _
Shoulder Size (G): ________________________(from tip of one shoulder to tip of other across the back)
Neck
Curcumference (B):		 ________________________  
Neck
to Shoulder (C):		 ________________________  
Shoulder to Wrist (D): ________________________  
 Comments/changes:   _____________________________________________________________________
 Quantity: _________  Unit price :_________  Shipping:________  Insurance:_________ Total:____________

Other Comments:

Shipping Charges - € Euro
Priority Mail - Great Britain & Europe
takes 2-3 weeks delivery
Contents value: € Shipping Cost: €
1.00
36.00
76.00
141.00
201.00
301.00
 to 35.00 = 18.00
to 75.00 = 19.00
to 140.00 = 24.00
to 200.00 = 27.00
to 300.00 = 30.00
to 500.00 = 34.00
Insurance = €5
Shipping Charges - € Euro
Economy Mail - Great Britain & Europe
takes 2-3 weeks delivery
Contents value: € Shipping Cost: €
1.00
36.00
76.00
141.00
201.00
301.00
 to 35.00 = 5.50
to 75.00 = 7.60
to 140.00 = 8.00
to 200.00 = 8.40
to 300.00 = 9.00
to 500.00 = 10.00
Insurance = €5
Shipping Charges - $ US Dollars
Priority Mail - USA & Canada
takes 2-3 weeks delivery
Contents value: $ Shipping Cost: $
1.00
36.00
76.00
141.00
201.00
301.00
 to 35.00 = 20.00
to 75.00 = 25.00
to 140.00 = 30.00
to 200.00 = 35.00
to 300.00 = 40.00
to 500.00 = 45.00
Insurance = $5
Shipping Charges - $ US Dollars
Economy Mail - USA & Canada
takes 2-3 weeks delivery
Contents value: $ Shipping Cost: $
1.00
36.00
76.00
141.00
201.00
301.00
 to 35.00 = 10.00
to 75.00 = 12.00
to 140.00 = 16.00
to 200.00 = 18.00
to 300.00 = 20.00
to 500.00 = 25.00
Insurance = $5
Cheque  Money Order  Master Card  Visa  Access
Total $:          _______________________
Expiry Date : _______________________ 
Card Number:

Signature______________________________________
Credit Card Billing details: Delivery details: (if different from billing details) 
Name _______________________________ Name _______________________________
Street _______________________________ Street _______________________________
City/State/Zip _______________________________ City/State/Zip _______________________________
Phone # _______________________________ Phone # _______________________________
Email address _______________________________ Email address _______________________________