chain order form

Order Form

Fill In this form then click 'PRINT'. Our prices are quoted in Australian Dollars. We accept
cheques (after clearance) credit cards and money orders. All payments will appear on your Credit
Card Account in the name of Amardio Jewellery. Email, Fax [61 0740414799 or AIRMAIL
your order to:-
Amardio Jewellery Cairns 4870
QUEENSLAND AUSTRALIA
advising which transport method suits you, and we will email you advising the exact amount owing.

QTY DESCRIPTION

BILLING

Credit card

Cardholder name

Card number

Expiration date

Please provide the following information:

Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

E-mail

Please debit my card for Order Total (including Freight and Insurance):

PRICES CAN VARY DUE TO CHANGES IN CURRENCY RATES. ALSO FREIGHT COSTS WILL DEPEND ON THE WEIGHT
OF YOUR PURCHASE AND WHERE YOU LIVE. INSURANCE COSTS WILL DEPEND ON THE AMOUNT OF THE
PURCHASE. PLEASE Email, OR FAX US [Fax No.61 0740414799] FOR THE EXACT AMOUNT.
Last revised: April 19, 2000

	BILLING
Credit card
Cardholder name
Card number
Expiration date

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
E-mail