Your Name:
Your Address:(This address will be used for shipping purposes)
Daytime Phone:(incl. area codes)
Country:
Your E-Mail Address:
METHOD OF PAYMENT:
Entering your credit card number is optional. If you are concerned with Internet Security, just fill out the Form, leaving the credit card info blank. I will call you at your daytime phone number to get your payment information or you may print out this form and mail to ASTOR TRADING P.O.Box 129 REDCLIFFE QLD AUSTRALIA 4020(including a "INTERNATIOANAL MONEY ORDER or CASHIERS CHECK)MY PHONE # +61 7 32027276 FAX # +61 7 32038895
Card #:
Expiry Date:
Jewellery Items Ordered:
Please type in the catalogue numbers and description of the jewellery you wish to order:-
Sub Total($US):
Please
email me for more information on shipping, handling and insurance for orders outside of Australia!
Please debit my card for Order Total(including shipping):
($US)
Further information?:
mailto:astor_oz@bigpond.com"