Fax/Mail Order Form
	Australian Collection Tel: 61-2-9231 5222 Fax: 61-2-9231 5522 info@AustralianCollection.com.au	Shop C24 Centrepoint Shopping Centre 100 Market St, Sydney NSW, 2000, Australia

To avoid online security problems with your credit card details we also accept fax or mail orders.
To make an order please print this page, fill in the details and then either fax or mail it to us.
If you don't have a printer or fax then please call us and place your order by phone.

Payment may be made by credit card or bank cheque/money order.
Personal cheques will be accepted after they are cleared. This may cause a slight delay in delivery.
Use Currency Converter for currencies other than AUD.

First Name:	Last Name:
Street:
City:	Country:
Postcode/Zip:	Phone:
Fax:	E-mail:
Payment Type
Bank cheque/Money order/cheque:	Made payable to: Australian Collection
Credit Card Number:
Expiry Date:	Signature:
Credit Card Type:
(Credit Cards Accepted: Visa, MasterCard, Bank Card, Diners, American Express, JCB)

Item	Description	Qty	Size	Color	Price	Total

Shipping & Insurance:

Sub Total:

Currency Converter  Total Cost ($AU):