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ORDER FORM FOR IRISH MASONIC RECORDS

Name (block capitals)

___________________________

Address

___________________________

___________________________

Signature

___________________________

Date

___/______/200_

I would like to order the digital edition of Irish Masonic Records
I confirm that I have access to a system which uses MS Windows 98

Items required :-

CDs at a cost of £30 / $45 / €45 per copy

  Number Required = _________

On receipt of confirmation of this order from Bro. Cochrane I will forward a sterling cheque made payable to :-

 Keith Cochrane
37 Knockdene Park South
Belfast
BT5 7AB
N. Ireland

I agree to my name being kept on a Register to be held by Bro. Cochrane on a computer system purely to enable him to contact me regarding further up-dates to this collection which will, from time to time, be issued by him at the production cost only, plus postage.