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PERMANENT MEMORIES Wangaratta Vic 3677 ABN 74 083 491 285 www.mooreslrweather.com.au/permanentmemories Email moores9@westnet.com.au |
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Print then Post or Fax to: To Permanent Memories P O Box 445 Wangaratta Vic Australia 3676 Phone/Fax 61 +03 5721 9792 Email: moores9@westnet.com.au
ORDER FORM AUSTRALIA What Have You Chosen? - Booklets (Please Circle Order) Sales VIC Postcodes Sales Other State Postcodes (1) 1 Booklet inc P & P for $5.00 (7) 1 Booklet inc P & P for $ 5.00 (2) 5 Booklet inc P & P for $22.00 (8) 5 Booklet inc P & P for $ 22.00 (3) 10 Booklets inc P & P for $37.00 (9) 10 Booklets inc P & P for $ 37.00 (4) 20 Booklets inc P & P for $64.00 (10) 20 Booklets inc P & P for $ 64.00 (5) 40 Booklets inc P & P for $90.50 (11) 40 Booklets inc P & P for $ 93.50 (6) 100 Booklets inc P & P for $211.00 (12)100 Booklets inc P & P for $215.50
Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . . .
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Phone . . . . . . . . . . . . . . . . . . . . . . . .E-mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
May I order . . . . . . . . . . . . . . . . . . booklets.
Please find enclosed my cheque/money order for $ . . . . . . . . . . . . .
Or I have direct deposited to Bendigo Bank BSB 633 000 Account No 127604791 Please put your Initial and Surname with deposit, so it can be recognised and then email me at moores9@westnet.com.au in order that I am aware of the number of booklets being ordered, the deposit being made and the delivery address.
Name on Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Signature . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . Expiry Date. . . . . . . . . . . . . . . . . .
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