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MAIL AND FAX ORDERS ARE ONLY ACCEPTED FROM AUSTRALIA AND NZ

The Crewel Gobelin
Order Form

Name:.........................................................
	
Street Address:...............................................
	
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City/Town:..................................... Postcode:.....
	
State:....................Country:............................
	
Home phone:......................Facsimile:....................
	
Business phone:................................................
	
Email address:.................................................
	
Order Instructions:
	
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Please Contact us for the cost of Postage


Choose one:
	
1. I wish to pay by cheque.Telephone : 02 9498 6831 Fax: 02 9499 5001
   or email us at enquiries@thecrewelgobelin.com.au to find out
   Postage charges.	 
	
2. I wish to pay using my credit card
	
	 Mastercard/ Visa/ Bankcard   (Please circle)
			 
	 Name on card:.........................................
    
    Card Number: .........................................
		 
	 Expiry Date:..........................................
		 
	 Signature:............................................