| Name: |
| Address: |
| Address: |
| State: Postcode: |
| Country: |
| Telephone: Daytime: |
| Between 6pm and 8pm: |
| Mobile: |
| Fax: |
|
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] |
| Bankcard: Mastercard: Visa: |
| Card Number: Expiry Date: |
| Name as it appears on the card: |
| Signature: |
| |
| Mail to:
Equileisure, c/o Post Office, Upper Beaconsfield,
VIC 3808, Australia |
|
Thanks for Shopping at Equileisure |
|
Best Regards, Glennis |
|
| 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 |
