QUALITY RECORDS...plus
263 Glenferrie Road, Malvern, Victoria, Australia 3144 Phone or Fax: +61+3+9500 9902
ORDER FORM
PRINT FROM YOUR BROWSER, FILL OUT THEN FAX OR POST US THIS FORM (DO NOT EMAIL)
Surname: Given Names:
Postal Address:
Post\Zip Code:
Phone Number:
Email Address:
Method of Payment:
Credit Card (please tick)
Visa: Bankcard: Mastercard: American Express: Diners
Club:
Card Number: Expiry Date:
Cheque\Money Order:
Please find enclosed a Bank cheque or Money Order to the value of AUS$
Please send me the following items: (include ITEM COST, POSTAGE and TOTAL)
ARTIST |
TITLE |
COST |
Total item cost = |
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+ Postage*= |
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TOTAL COST = |
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*For local and international POSTAL RATES see HOW
TO ORDER
OPTIONAL - If you wish us to keep a record of your details so that future orders
can be processed more easily then please tick this box: (Note: this is NOT an
extension of credit)
Yes, I would like you to establish an account
in my name.