Name: |
| Address: |
| City: |
| State: Postcode: |
| Country: |
| Telephone Daytime: |
| Telephone Between 6pm and 8pm: |
| Mobile: |
| Fax: |
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Email: |
| Title: |
| Author: |
| Code: Book or Video: |
| Price: Quantity: |
| Title: |
| Author: |
| Code: Book or Video: |
| Price: Quantity: |
| Title: |
| Author: |
| Code: Book or Video: |
| Price: Quantity: |
| POSTAGE:
TOTAL
TO BE PAID incl. Postage: |
| Pay by: [please tick] |
| Cheque:
Money Order: COD: $10.00 surcharge |
| Credit Card: [please tick] |
| Mastercard:
Visa: |
| Card Number: Expiry Date: |
| Name as it appears on the card: |
| Signature: |
| |
| Mail to:
Equileisure, PO Box 295, Upper Beaconsfield, Victoria 3808, Australia |
|
Thankyou for Shopping at Equileisure |
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| Postage & Packing
Charges:
Australia International |
| Book/Video value:
$1-$200 $12
$35 |
|
Book/Video value:
$200-$400
$20
$70 |
|
Book/Video value:
$400-$1000
$30 $150 |
