ZARIM DESIGNS ORDER FORM

 

 

Name

 

 

Address

 

 

State Telephone

 

Country Mobile

 

 

PostcodeE-mail

 

 

 

 

STYLE

 

 

SIZE

 

MAIN

COLOUR

 

TRIM

COLOUR

 

BRAID

COLOUR / DESCRIPTION

 

 

 

PRICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSTAGE

 

TOTAL

 

 

 

 

 

METHODS OF PAYMENT

 

ž Cheque (Payable to Zarim Designs)

 

ž Visa ž Mastercard ž Postal Order  ž Direct Deposit (contact Zarim Designs for details)

 

 

Card No

 

 

Expiry Date

 

 

Cardholder Name

 

 

Signature

 

Zarim Designs

10 Ashwood Close, Ocean Grove

Victoria 3226 Australia