1821 Pakowhai Road
R.D.  3
Napier  4183
New Zealand

Phone & Fax:  +64  6  878  1260

Contact:  Sherelyn Whiteman

Order Form :  Order by phone, fax or mail
 
Name:   (Please print)   ....................................................................................   Date:  ..................................
Address:  ..................................................................................................................................................
City:   ...................................................................     State / County:   ......................................................
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Office

Use

Code

Description / Design Title

Qty

Price

Invoice #

B/O
           
           
           
           
           
           
           
           
           
           
           
Shipping & Handling Charges:

Sub Total

 

Account #
Within NZ  ......   $5.50

Shipping  & Handling

    
International   .....   $10.00 up to 100 grams, thereafter actual costs

Total

    
Method of Payment: [      ]   Cheque enclosed
  [      ]   Please charge my Credit Card :   [      ]   Visa           [      ]   Mastercard
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Expiry Date:   ........................................     Signature: ...................................................................................