ORDER FORM - Block of the month – SNUGGLE BUGS
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$31.00 per month for 10 months plus $3.00 postage & handling within Australia (overseas postage extra) OR
2. YES - I would like to take advantage of the 10% discount offer and pay A$279.00 on one payment plus $11.00 postage and handling (overseas postage extra). And receive my quilt over 10 months OR one delivery OR
3. YES – I would like to order the pattern only (available from June /July 2010) for A$12.10plus $2.00 postage & handling . OR
4. I would like to purchase the 10 patterns in a single deliver  at $108.90 (10% discount)  plus $6.00 postage within Australia (overseas extra)

METHOD OF PAYMENT

Circle as appropriate

Charge my - VISA - MASTERCARD – AMERICAN EXPRESS or Send me PAYPAL invoice at the time of each delivery under option 1 , 3 and 4 or with the first delivery for options 2
or

PAID BY - MONEY ORDER - CHEQUE

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

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	Paid or C/C Charged	Date Mailed
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 7
Block 8
Block 9
Block 10