Order Form

1. Please fill in relevant sections so that your order can be processed quickly.

Name or Company :

Address:

Town : 

State : 

Postcode :

Country : 

Phone :

Bus Phone : 

Fax : 

E-Mail : 

A.B.N. No.: 

Order No. (if applicable):

 

2. MODEL CODE & DESCRIPTION

Note: All prices are GST inclusive.

QUANTITY

PRICE 
EACH

TOTAL

3. HANDLING AND SHIPPING CHARGE

   

$15.00

 

4. TOTAL CHARGE INCL. GST 
Please add the Handling & Shipping charge.

 $         

5. METHOD OF PAYMENT

*Account option - to preapproved customers only
*Cheque option - for mail orders only
ACCOUNT
CREDITCARD
CHEQUE
PLEASE CHARGE MY CARD
BANKCARD
MASTERCARD
VISA
CARD NUMBER:
EXPIRY DATE:

FULL NAME ON CARD:

FOUR EASY WAYS TO ORDER FROM A.M.DUNGEY PTY.LTD.

You can submit the form via email or to print out the form click on it and select the print option, then send it via fax or snail mail.

MAIL

FAX

PHONE

 SUBMIT

PO Box 158, 
Daw Park, 
South Australia, 
AUSTRALIA 5041

08 8271 8662

08 8271 8886 

* Handling and Shipping charge is valid only for Australian residents, for
overseas residents please enquire.

© Copyright 1999 A.M. Dungey Pty. Ltd. All rights reserved.

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