ORDER FORM - Block of the month – SONG BIRD
PRINT - Complete and send to:-

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$33.90 per month for 10 months INCLUDING FREE POSTAGE  within Australia & New Zealand (other overseas postage extra) OR
2. YES - I would like to take advantage of the 10% discount offer and pay A$305.10 on one payment plus $15.00 postage and handling Australia & New Zealand (overseas postage extra). And receive my quilt over 10 months OR one delivery OR
3. YES – I would like to order the pattern only (available from June /July 2012) for A$9.90plus $2.00 postage & handling . OR
4. I would like to purchase the 10 patterns in a single deliver  at $99.00  plus $6.00 postage within Australia & NEw Zealand (other overseas extra)

METHOD OF PAYMENT

Circle as appropriate

Charge my - VISA - MASTERCARD – AMERICAN EXPRESS or Send me PAYPAL invoice at the time of each delivery.
or

PAID BY - MONEY ORDER - CHEQUE (Money Order and Cheques are available to Australian Customers ONLY

Customer to Complete

Lyn’s Needlework Use Only

Card Number   _ _ _ _   / _ _ _ _  / _ _ _ _  / _ _ _ _

Expiry Date   _ _ / _ _   Security Code  _ _ _

Name on Card  ________________________

Email address  ________________________

Signature  ____________________________

Delivery Address:

Name  _______________________________

Address  _____________________________

City;_______________ Post Code ________

Phone (_____)  ________________________

BLOCK	Paid or C/C Charged	Date Mailed
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 7
Block 8
Block 9
Block 10