ORDER FORM   - Block of the month – MENAGERIE

JEANETTE

LYN’S FINE NEEDLEWORK

Suite 2 / 9 SEVEN HILLS ROAD

BAULKHAM HILLS   NSW  2153

AUSTRALIA .
Phone / fax  -  (02) 9686 2325   -     from outside Australia +(612) 9686 2325

Email – lynsneedlework @aol.com


 Circle as appropriate

  1. YES  - I would like to order the BLOCK OF THE MONTH OFFER    for A$35.00 per month for 9 months inclusive of postage & handling within Australia and New Zealand (other overseas postage extra)   OR
  2. YES - I would like to take advantage of the 10% discount FARIC OFFER offer and pay A$290 in one payment inclusive postage and handling Aust & NZ (other overseas postage extra). And receive my fabric  over 12 months   OR   one delivery   

METHOD OF PAYMENT

Circle as appropriate

 Charge my     -   VISA   -  MASTERCARD –  AMERICAN EXPRESS  or Send me PAYPAL invoice   at the time of  each delivery.  or

PAID BY    -   MONEY ORDER   -  CHEQUE    

                      (Money Order and Cheques are available to Australian Customers ONLY for purchase options 2 ) 
Customer to Complete Lyn’s Needlework Use Only
Card Number   _ _ _ _   / _ _ _ _  / _ _ _ _  / _ _ _ _
 
Expiry Date   _ _ / _ _   Security Code  _ _ _

Name on Card  ________________________

Email address  ________________________

Signature  ____________________________

Delivery Address:

Name  _______________________________

Address  _____________________________

City;_______________ Post Code ________

Phone (_____)  ________________________

BLOCK

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