ON-LINE ORDER FORM
Customer Name:
Address:
P/Code:
Telephone:
Fax:
E-mail:
Mobile:
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YOUR ORDER DETAILS
Description:
Quantity:
Colour:
Size:
Price:
Description:
Quantity:
Colour:
Size:
Price:
Description:
Quantity:
Colour:
Size:
Price:
Description:
Quantity:
Colour:
Size:
Price:
PAYMENT OPTIONS
Personal cheque
with ID noted on the back of cheque.
Mail to: 52 Hawkesbury Drive, Willetton WA 6155
Direct Payment
into Moira's Urban Palette Account. Details available by email.
We will accept cheques with goods being despatched after clearance.
POSTAGE & HANDLING
For orders within Australia totalling:
Up to $25
- $10.00
$25.01 - $50.00
- $13.00
$50.01 - $75.00
- $15.00
$75.01 - $150.00
- $17.00
$150.01 - $350.00
- $19.00
$350.01 and over
- $21.00 and up
Costs for orders outside Australia need to be calculated individually.
PAYMENT TOTAL
• Merchadise Total
• Postage & Handling
• Total
