Fax Order Form

Print this page and return via fax or mail to:  55 Knowles Ave, Matraville, NSW, 2036

Phone / Fax: +61 (0)2 9311 7270

Home Page

all prices include GST

Order Code Product Description Qty Unit Price Postage Total Amount
           
           
           
           
           
           
           
           
Insurance at $2 per $100 is advised to cover loss or damage whilst in transit until the goods reach your door. Goods left at front doors or otherwise unattended are not covered.

Sub Total

 

Insurance

 

Total

 
Name: _________________________________________________
Insurance:  Yes  /  No     please circle

Delivery Address:_________________________________________

                    _________________________________________
Phone No: ________________    email: ______________________

Credit Card:     VISA  /  MasterCard     please circle

Number: __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __

Expiry Date:  __ __ / __ __ __ __

Card holder name: ________________________________________

Cardholder signature: ______________________________________

Please fax this form to +61 (0)2 9311 7270