Hugh Thomson Puzzle Order Form

Micro puzzles are 12 cm x 8.2 cm They are not suitable for children under the age of 3 Puzzles contain 40 pieces, including irregular shaped pieces which relate to each image, e.g rabbits, birds, crowns, etc…

HT1 HT2 HT3 A study from ‘A Peep at the Dear Oldies’ ‘Bridge over the Bann at Shakespeare’s ‘As You from Mrs Molesworth’s ‘This Kilrea’ by Hugh Thomson Like It’ by Hugh and That: A Tale of Two Thomson Tinies’ by Hugh Thomson

Please complete the table below to place your order:

Puzzle code Price each Quantity Total price HT1 £5.95 HT2 £5.95 HT3 £5.95 Plus Postage + Packaging UK - £3.00 Overseas - £4.00 Total *If purchasing more than one puzzle please contact us to confirm postage cost (contact details below)

Name: Payment method (please tick one) Delivery Address: Cheque made payable Credit/debit card to ‘Coleraine Borough Council’ Please complete your credit/debit card details below:

Card Type: Postcode: Issue Num: (if applicable) Email Address: Card Num:

Security Num: Please return this form by post to: Sarah Carson, Leisure Services Dept., Valid from: Cloonavin, 66 Portstewart Road, (mm:yyyy) Coleraine, Co.Londonderry, N.Ireland Valid to: BT52 1EY or by email to: (mm:yyyy) [email protected] Puzzles can be collected from Signature: Cloonavin to save on P+P, please contact Sarah Carson on *If you would like to be added to our mailing address please tick: 02870347213 to arrange this. We can also accept cash payments at Cloonavin.

THANK YOU FOR YOUR ORDER! 1 2