ORDER FORM -
Block of the month – NOAH & FRIENDS

PRINT - Complete and send to:

CONTACT:

JEANETTE

LYN’S FINE NEEDLEWORK

Suite 2 / 9 SEVEN HILLS ROAD

BAULKHAM HILLS NSW 2153

AUSTRALIA .

Phone / fax - (02) 9686 2325 - from outside Australia +(612) 9686 2325

Email – lynsneedlework @aol.com

Circle as appropriate

1. YES - I would like to order the BLOCK OF THE MONTH OFFER for A$25 per month for 10 months PLUS postage & handling OR
2. YES - I would like to take advantage of the 10% discount offer and pay A$225.00 on one payment PLUS postage and handling And receive my quilt over 10 months OR one delivery OR
3. YES – I would like to PURCHASE the pattern only for A$88.00 plus postage & handling OR

METHOD OF PAYMENT

Circle as appropriate

Charge my - VISA - MASTERCARD at the time of each delivery under option 1 or with the first delivery for options 2 & 3
or

PAID BY - MONEY ORDER - CHEQUE

(Money Order and Cheques are available to Australian Customers ONLY for purchase options 2 & 3)

CARD NUMBER ___ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

EXPIRY DATE __ __ / __ __

NAME ON CARD ___________________________________________________

Email address _______________________________________________________

Signature _________________________________

DELIVERY ADDRESS
Name; __________________________________________________

Address _________________________________________________ ___________________________ Post Code

Phone (____) ________________________