Secure Online Order Form

This form allows you to place orders for CDs from the Lyrita Catalogue either on-line, by completing the form and pressing the "Place Order" button, or by printing the completed form and faxing or posting it to PO BOX 87, Monmouth, NP25 3WX, UK, fax no (+44) 1600 891 052.

For the form to work correctly, your browser must be capable of running JavaScript. It has been tested with browsers from Netscape, Microsoft, Mozilla and Opera, and should work with any browser with a version number of 4 or greater. If your browser is older than this or if you have JavaScript switched off, you will not be able to use this form correctly. If you have any questions relating to this you can contact me at webmaster@lyrita.co.uk.


Section 1. Delivery and Contact Details


You must at least fill in all the boxes marked with a * for the form to be successfully submitted.

NB. If your shipping address is different from the address at which your payment card is registered, please enter the address at which your card is registered in the Additional Comments box in Section 3 below. Failure to do this may make it impossible to process your payment.


Full Name *
Address Line 1 *
Address Line 2   
Address Line 3   
Town / City *
County / State   
Postcode / Zip *
Country *
E-mail Address *
Phone Number   

Section 2. Order Information


Fill in the numerical part of the catalogue number in the left hand column (ie. ignore the SRCD. or REAM. prefix, and just enter the numbers that follow) and the quantity of each CD you wish to order. The form will automatically fill in all the other columns and calculate the total value of the order.


Cat. No Title Quantity Price Postage Total
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 
SRCD/REAM £  £  £ 

Order Total:  £ 

Section 3. Additional Comments


If you have any additional requirements or comments relating to your order, please add them here.

NB. If your shipping address is different from the address at which your payment card is registered, please enter the address at which your card is registered here. Failure to do this may make it impossible to process your payment.


Section 4. Method of Payment


If you wish to pay by credit card, please fill in the section below and click the Place Order button. The information on this form will be securely encrypted and e-mailed to us for processing.

If you have a Maestro card with 18 digits rather than 16 in the long number on the middle of the card, please select "Maestro (18 digit)" from the Card Type drop down box, and the last box will allow you to put in 6 digits rather than 4.

If you wish to pay by cheque, please print this form and post it, with a British pounds cheque for the value in the Order Total box above to PO BOX 87, Monmouth, NP25 3WX, UK. Cheques should be made payable to Wyastone Estate Limited.

If you are using this form to order discs, you must at least fill in all the boxes marked with a * for the form to be successfully submitted.


Credit card type *
Name as it appears on the credit card *
Card number *
Start date  (Required for Switch / Solo / Maestro cards)
Expiry date *
Issue number * (Required for Switch / Solo / Maestro cards)
Security number * (The last three digits on the signature strip on the back of your card)

Section 5. Place the Order