ORDERFORM

Your name and address:			Your Shoe Order:
			Our Style Code:
			Your usual size:
			Measurements:	Left Foot:	Right Foot:
			A:
			B:
			C:
Phone:			D:
Mobile:			E:
Email:			F:

Working out the price:			Your preferences:
Price of Footwear			Colour ( check if available with your chosen style): saddle-tan  O         medium brown O             dark brown  O mahogany O                      black O          custom dyed  O
Heel Cushion (avail with all shoes) £5.00
Triangular Heel Riser £25.00 Small extra Heel £20.00 Second Leather Sole glued on £30.00			Do you want a triangular heel-riser with your Dark-Age Shoes?  £25.00      O (check if available with your style - no small extra heels or second sole layers with this)
Vampstripe  Plain (early medieval) £20.00 Vampstripe Silk (high medieval) £25.00			Do you need extra room for thermal insoles or socks that were NOT included when taking measurements? Note: NO orthopaedic insoles to be worn with ANA shoes unless agreed otherwise.
Openwork per pair of rows £20.00			Will additional sole-layers be glued on by a modern cobbler?                     O  (We will NOT oil your shoes so that their modern glue sticks better)
Postage within UK per pair Machine-sewn shoes/boots  £5.00 Hand-sewn shoes £8.50 Hand-sewn boots £12.00 Wooden Pattens £8.50			How did you hear about us?
Total			On which occasions will you wear our footwear?

If ordering more than one pair:
Please staple the order forms to the foot-drawings they belong to as this avoids misunderstandings.
Contact us for the correct postage for the entire parcel as you may be eligible for a discount.

Checklist:
•Completed order form
•Outline of your foot and measurements
•cheque  made payable to A. DEISSLER

When your order is complete please post it by ordinary mail to:

ANA, 26 Vicarage Terrace, Treorchy, Mid Glamorgan, CF42 6NA, Great Britain

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© Ana Deissler 06-2017