|
2 |
Daytime Phone |
................................................................
*REQUIRED |
|
Fax |
................................................................
*Optional
|
|
E-mail |
................................................................
*Optional
|
|
WHICH
SEAT PAD ?
COLOUR
QUANTITY |
|
3 |
CRUISER Seat Pad |
Black
/ Black
/Black
/Black |
|
SOLO Seat Pad |
Black
/ Black
/Black
/Black |
|
MINI Seat Pad |
Black
/ Black
/Black
/Black |
|
POSTAGE
CHARGE DETAILS
|
|
4 |
Charges |
Air Mail
.................................... AUD$ 17.00
EMS [Air Mail Express] ............ AUD$ 40.00 |
|
|
|
|
|
|
PAYMENT
DETAILS
|
|
5 |
Card Type |
VISA / MasterCard / Bankcard
*REQUIRED |
|
Card Number |
_ _ _ _ -
_ _ _ _ - _ _ _ _ - _ _ _ _
*REQUIRED |
|
Card Expiry |
Month ___ ___ *REQUIRED
Year ___ ___ *REQUIRED |
|
Name on Card |
................................................................
*REQUIRED |
|
SEND
YOUR ORDER |
|
6 |
Agreement |
When you Fax/Mail this Order you are agreeing:-
that all information supplied is "true and correct";
that you are the authorised user of the credit card;
that you are authorising a one time only transaction;
that any postage and local tax will also be charged with this transaction;
that you, the purchaser, are liable for any import/customs fees:
that you understand ALL prices and payments are in Australian dollars;
that you understand that manufacture and delivery times are "approximate
times";
that you have read this agreement.
|
|
FAX to :- |
+61 7 3881 3389 |
|
MAIL to :- |
SHEEPY HOLLOW
PO Box 5094
Brendale
Qld Australia 4500 |