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 9368
Harris Park  NSW  2150

60 Prospect Street,
Rosehill
NSW 2142

Phone, Australia
Phone New Zealand
Fax
email

Australia 02 9897 3118
New Zealand 0800 738 695
Fax +61 2 9637 8052
e-mail supplies@rotarydownunder.com.au