| Mail to: | SAMS Handcrafts 35 OAKTREE RD CROYDON VICTORIA 3136 AUSTRALIA |
| ITEM NAME | NO. REQ | COLOUR | PRICE | TOTAL | |
| TOTAL VALUE | |||||
| Post and packing will be added at cost. | |||||
NAME OF PURCHASER: ___________________________
ADDRESS: _____________________________________
_____________________________________
_____________________________________
_____________________________________
TELEPHONE: ___________ E-MAIL: ______________
DESIRED DELIVERY DATE : ______________________
Delivery method: PICK UP POST/COURIER DIRECT GIFT (circle one)
Please charge this purchase to my credit card as detailed below:
VISA MASTERCARD (circle one)
Name on card: ____________________________
Full Card Number: _______ _______ _______ _______
Valid from _____/_____ to _____/_____
Signature of cardholder: _________________________________
Please confirm delivery charges with me before dispatch.
Please telephone me for credit card details
Please telephone me with total cost as I wish to pay by cheque