ORDER FORM -
Block of the month – PLAYING WITH ANGELS

PRINT - Complete and send to:-

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$37.95 per month for 9 months including postage & handling within Australia (overseas postage extra) OR
2. YES - I would like to take advantage of the 10% discount offer and pay A$307.40 on one payment including postage and handling (overseas postage extra). And receive my quilt over 9 months OR one delivery OR
3. YES – I would like to order the pattern only (available from August 2009) for A$89.10 plus $5.00 postage & handling OR
4. YES – I would like to receive one pattern a month at $9.90 + $2.00 postage per month for 9 months (overseas postage extra)

METHOD OF PAYMENT

Circle as appropriate

Charge my - VISA - MASTERCARD at the time of each delivery under option 1 and 4 or with the first delivery for options 2 & 3
or

PAID BY - MONEY ORDER - CHEQUE

(Money Order and Cheques are available to Australian Customers ONLY for purchase options 2 & 3)

CARD NUMBER ___ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __

EXPIRY DATE __ __ / __ __ Security Code__________

NAME ON CARD ___________________________________________________

Email address _______________________________________________________

Signature _________________________________

DELIVERY ADDRESS
Name; __________________________________________________

Address _________________________________________________

City ___________________________ Post Code_________________

Phone (____) ________________________