CHRISTMAS CATALOGUE 2014 ORDER FORM YOUR DETAILS ORDER FORM

CHRISTMAS CATALOGUE 2014 ORDER FORM
ORDER FORM
DESCRIPTION
YOUR DETAILS
PRICE
QTY
TOTAL
First Name:
Last Name:
CHRISTMAS CARDS (per pack of 10)
Wrens with Tinsel
$9.00
$
12 Days of Christmas
$9.00
$
Aussie Animals
$8.00
$
Christmas Trees
$8.00
$
Address:
Suburb:
State:Postcode:
Contact Number:
Email:
CHRISTMAS GIFTS
Christmas Tea Towel
$15.00
$
Australian Bush Ballads
$15.00
$
Just Soup Cookbook
$15.00
$
Sub Total
PAYMENT DETAILS
Total Payment: $
We will endeavour to process your order within 7 days of receipt.
Please allow up to 7 working days for delivery.
Please find enclosed:
$
Cheque / Money Order (payable to Parkinson’s Victoria)
POSTAGE AND HANDLING (not applicable for gift card)
OR charge my:
Orders $20 and under
$6.00
$
Order from $21 to $65
$9.00
$
Order over $65
$12.00
$
Name on card:
$
Signature:
Sub Total
$45.00
Sub Total
Card Expiry:
CVV Code:
All Christmas cards and gifts available while stocks last. Do not send cash in the post.
Please detach completed order form and return with your cheque, money
order or credit card details in the enclosed Reply Paid Envelope to:
$
Parkinson’s Victoria
8B Park Road
Cheltenham VIC 3192
Or email to: [email protected]
$
ABN: 68 038 728 034
DONATIONS
I would like to make a donation to
Parkinson’s Victoria.
Mastercard
Card Number:
PARKINSON’S VICTORIA GIFT CARD
(100% tax deductible with no postage and handling fee)
Gift Card
VISA
$
(Donations $2 and over are tax deductible)
For more information about Parkinson’s Victoria’s membership
and support for people living with Parkinson’s:
TOTAL PAYMENT DUE
Call (03) 9581 8700
Free call 1800 644 189
or visit our website:
GST Tax Invoice (for business only)
$
While stocks last.
parkinsonsvic.org.au
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