MODEL WITHDRAWAL FORM
To:
*
Please Select
The Store by P.Cutajar
WineClub by The Store
Solaris Sliema
Coccinelle Sliema
Business Address - The Store
The Store, Capital Business Centre, Triq Taz-Zwejt, Industrial Estate, San Gwann
Business Address - Wine Club
The Store, Capital Business Centre, Triq Taz-Zwejt, Industrial Estate, San Gwann
Business Address - Solaris
Solaris, 7, Tower Road, Sliema
Business Address - Coccinelle
Coccinelle, 11, Tower Road, Sliema
I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods/for the provision of the following service:
*
Ordered on/Received on:
*
-
Day
-
Month
Year
Date
Name of Consumer:
*
First Name
Last Name
Email
*
example@example.com
Address of Consumer
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Signature of Consumer:
*
Contact Type
*
Please Select
Send Form by Email
Send Form by Post
Once you click submit the form will still be sent automatically to our head office for further processing. You will be contacted by the respective shop. If you selected the Contact Type: "By Post" you need to print the PDF, which is received automatically after you click submit and send it by post.
Submit
Should be Empty: