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
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 |