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Mail / Fax Order
Form - Please
print this form, fill it in then fax
or mail it.
| Name |
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| Address |
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| City |
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| State |
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| Post
Code / Zip Code |
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| Country |
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| Phone |
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| Email |
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| Qty |
Product
Code |
Description |
Price
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Freight
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Total
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Payment
Type
(please
circle)
|
Amex |
Visa |
Diners |
MasterCard |
BankCard |
Cheque |
| Card
Number |
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| Expiry
Date |
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| Name
on Card |
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| Fax to: |
Mail to: |
Argyle
Jewellers Garden City |
| 61 7 3349
0272 |
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Shop
1049
Garden City Shopping Centre
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Cnr
Logan and Kessels Road
Upper Mt Gravatt |
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Brisbane,
QLD 4122 Australia |
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