Painless Public Speaking : ORDER FORM

Online Order form

Please use our quick order form to book your session time or to prepay for your session.
Please note: Your card will NOT be processed without your emailed authorisation.

Name of item (deposit, full prepay, postpay, booking security)

Amount: (deposit or full payment)

Name on credit card:

Name of company (where relevant)

Phone number:
(please write area code in brackets )

Email:

Full name and Billing address:

Mailing address - only if DIFFERENT from billing address

Name:

Address:

My credit card details:

Type of card:

Visa
Mastercard

Credit Card Number (no gaps please)

Expiry date: (month & year)

Name of bank, city and country your credit card is issued in

Please write any comments that may help us process your booking eg urgent request, any other queries. These will not be recorded on your statement.
You can write in your booking request dates as well.

Please note: These details are only used for this specific order and will not be passed on.
Click ONCE for the form to submit.
It may take a few moments.
Thank you.