Please fill in the form below and then print it off using the "print" button in your browser.

You can then send it to:

                    Mick Bassett

                    (MB FLOATS)

                    17 Falcon Close

                    Broughton Astley

                    Leicestershire

                    LE9  6RT 

Or simply Telephone: (+44) 01455 284493             

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Please add £3 for postage and Handling (UK Only)

I enclose a cheque / PO for  made payable to: made payable to: Mick Bassett

Please provide the following contact information:

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