MAIL ORDER FORM

To:

KISMANA MUSIC      PO Box 1254                 Bentley DC                       6983 WA          AUSTRALIA

Phone/Fax:

+ 61 - 8 - 9367 9340 (International)

Phone/Fax:

 (08) 9367 9340  (Australia)

ORDER DATE:

Month:

Date:

Year:

SHIPPING ADDRESS:

Name:

 

Company (Optional):

 

Address (Line 1):

 

Address (Line 2 - Optional):

 

City/Town

 

State:

 

Postal/Zip Code:

 

Country:

 

Phone Contact # (Required):

 

Fax #:

 

Email Address (Required):

 

SHIPPING & HANDLING CHARGES

International:  Please include $6.00 for the first item and $3.00 for each additional one.

Australia: Please include $4.00 for the first item and $2.00 for each additional one.

NOTE: All parcels are sent airmail.  Your package should arrive within 7 - 14 days.

(Please make all payments payable in Australian currency.)

GOODS:

 

Item Code

Title

Qty

Price

Postage

Total

1.

 

 

 

 

 

 

2.

 

 

 

 

 

 

3.

 

 

 

 

 

 

Total amount payable (including postage) in Aud $: 

 

PAYMENT

  1.  I Enclose a Check/Money order made out to KISMANA MUSIC

          for the full amount of: (Aud$)  

Back to Order Procedure

 

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