Bankhouse Quilts - Australian Fabrics

Order

If you would like to make an order, please print this form and fax it back to Cheryl on +61 (0)8 8735 8602 or send to Bankhouse Quilts, Post Office Box 250, Beachport, South Australia, 5280, Australia. Alternatively, orders can be emailed through the email function above. Feel free to contact Cheryl with any queries by phone on +61 (0)8 8735 8602.

All pricing in Australian currency. Shipping will be arranged at purchasers request and expense.
Order Form
Mr/Mrs/Miss/Ms Name:____________________________________
Address: _________________________________ _________________________________________ _________________________________________					Phone Number:_______________________________
					Email:______________________________________
Fax Number:______________________________
Wishing to pay by:	Master Card	Visa	Cheque	( please circle one )
Name:_______________________Credit Card No._______________________ Exp. Date____________
Product:__________________________ Code:____________ Quantity:__________Price:$___________ Product:__________________________ Code:____________ Quantity:__________Price:$___________ Product:__________________________ Code:____________ Quantity:__________Price:$___________ Product:__________________________ Code:____________ Quantity:__________Price:$___________ TOTAL AMOUNT:$ __________________________
Any Comments: ______________________________________________________________________ ______________________________________________________________________________________

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