Ordering

Phone (03) 6393 6440
International Phone (613) 6393 6440
Fax (03) 6393 6064
International Fax (613) 6393 6064
E-Mail info@tascoppermetalart.com


To print this form, please right click your mouse and select print.
Fill in your order and fax it to the above fax number, or mail to
Tasmanian Copper & Metal Art Gallery,
1 Church Street, Carrick, Tasmania, 7291, Australia.


Name -
Address -
City - State -
Zip - Country
Phone - Fax -

Visa   Card Number  
Mastercard   Expiry Date  
Bankcard   Name on Card  

Ref No Qty Description

AU$
Each

AU$
Total
         
         
         
         
         
         
         
         
         
         
TOTAL  


Mastercard Bankcard Visa
Money Order and Cheque(Allow 10 days for clearance)
All prices are in Australian Dollars.