ORDER FORM



Simply complete the order form and return it with your cheque or credit card details to:

The Coombe Trust, 68 Manor Lane, London SE13 5QP

Simply complete the order form and return it with your cheque or credit card details to:

  • Up to 15 characters per line.
  • Spaces and punctuation count as characters (e.g.,.-!)
  • Write message below as you want it to appear e.g. UPPER and lower case.
  • Bosun’s Paver and Gone Home Paver = 2 lines.
  • Big Bosun’s Paver = 4 lines

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    Bosun’s Pavers

    Paver Details




    choose the lettering colour you want ( if applicable )

    Black (standard)
    Gold (optional at additional cost)

    The brick pavers 210mm x 105mm, engineering strength. 'Big brick' pavers are 210mm x 210mm The lettering is professionaly engraved and then coloured with longlasting black or gold infill.


    Captain’s Stones

    Stone Details





    Lettering in Gold beneath the Coombe Trust banner

    Cut from the finest quality granite, with polished face, carefully engraved and coloured. The Stone measures 400mm x 400mm.


    Gone Home Pavers

    Gone Home Paver Details






    Lettering in Black beneath the Gone Home symbol

    Manufactured to the same high standard as our Bosun's Pavers, these pavers measure 210mm x 105mm and will be placed in our Memorial Garden.


    Fill in your details

    Calculate your payment

    Bosun's Paver

    (210mm x 155mm)

    with 2 line of Black engraving

    with 2 line of Gold engraving

    £40   

    £50   

    The Big Bosun's Paver

    (210mm x 210mm)

    with 4 line of Black engraving

    with 4 line of Gold engraving

    £80   

    £95   

    The Captin's Stone Paver

    (400mm x 400mm)

    with 3 line of Gold engraving

    £1,000   

    The Gone Home Paver

    (400mm x 400mm)

    with 2 line of Black engraving
    below "Gone Home" symbol

    £40   
     

    Payment

    I hereby instruct you to debit my (please tick the box)

    Visa

    Mastercard

    Switch

    Valid From  

    Expiry

    Security No.

    Issue No.* (Switch card only)

    Gift Aid Statment
    I am a basic rate or above UK taxpayer and would like the Coombe Trust to claim gift aid on my donation.
    I confirm that the amount of tax I pay is more than the amount claimed against this donation.

    Points to note

    1. All pavers, remain the sole property of The Coombe Trust.
    2. The Trust reserves the right to approve all lettering and to refuse any application In such cases. The Trust has no obligation to cite reason.
    3. The Trust guarantee to maintain the path, the club reserves the right to move or relocate the bricks without liability.
    4. Although of excellent quality and designed to last, bricks may become wom or damaged over time owing to natural causes. No liability can be accepted for this by The trust.

    		  


    5. The Trust will have complete control over the location and installation date of the bricks.
    6. Any amendments to the inscription provided on the order form must be done within seven days of the receipt of the Certificate, thereafter The Trust is no longer responsible for the inscription. Amendments made within this deadline will be free if they are necessitated by an error on our part. However, if they involve a change from the original order a reasonable amendment charge may be made.
    7. Gone Home Pavers only, will be laid in the Memorial Garden by The Trust.