Order Form 
Were offering these items to the members of the Germany squad, 
please right click & print this page to order.          .



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If you won the Gold Medal in Germany we can offer you:  An Official WUMA World Title Belt

World Title Belt            59.99	Red with a bronze trim	one size	Amount required  [   ]
Sponsors name added free

 Only limited stock so please be quick with your orders for us to accommodate your requirements                                 

If you wish to pay by credit card fill in details:  Cardholders name:……………………………........…………………………….Card Type…………...................………………… 

Card No………............………………………………………………..…………..……………. Expiry Date:………........…………………………Issue No….........………………….

 Please state your order in full including sizes…………………………………………………………………………………………………………………………............................

 Signed………………………………………………………………………….………………………                                        Date……………......................………………………  

 Deliver to: Full Name ………………………………………………………… Full Address ……………………………...............................…………………………………………

 ………………………………………………………………………………………………………………………..............……………code….…………………………….....................
                                                
                                                      I enclose a payment of £3.95  for delivery [  ]       Total enclosed £................. 

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