Order Form
If you prefer not to order online, you can print this form, complete by hand and post with your cheque, or credit card details or, fax with your credit card details to Rotary Down Under or Rotary NZ as applicable..
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return to online catalogue

Prices include GST

ORDER REQUIREMENTS

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CODE #

Description

Size / colour

Total Price

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Postage will be added to invoice

Payment Details
please circle or underline preferred payment method

Enclosed is my cheque to the value of $ .............................................................................

Please debit my Bankcard / Mastercard / Visa / Amex / Australian Rotarians Visa

Card Number ../.../../.../.../.../.../.../.../.../.../.../.../../.../.../.../

Cardholder Name: (please print) ..........................................................................................

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Expiry Date: ........../......./......

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Signature ..................................................

Name ...................................................................................................................................

Delivery Address ..................................................................................................................

.............................................................................................................................................

State .................................................Post code ...................................................................

Contact numbers
at home - ph............................ Fax ............................ Email ...............................................

at work - ph .............................Fax ............................ Email ..............................................

Postal
PO BOX 244, TOONGABBIE
NSW 2146

Unit 16,
45 Powers Road,
Seven Hills
NSW 2147

NEW PHONE:, Australia
Phone New Zealand
email

02 9674 6855
0800 738 695
e-mail supplies@rotarydownunder.com.au