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ORDER FORM

Payment can be made by either ‘personal cheque’, ‘bank cheque’ or ‘money order’. Please make ‘cheques’ and ‘money orders’ payable to ‘HYPERCENTER’ and staple to the top of this form (please do not send cash).

Please contact us if you have not received delivery within 14 days.

Email: [email protected]

To order items, please print this page, complete all details, include payment and mail to:

HYPERCENTER

PO Box 651

Scarborough WA 6922

Australia

Please send me:

QTY	ITEM	UNIT PRICE	LINE TOTAL
	Album “Split Lip Shit” (limited edition)	$12.00 (US)* each
	T.Shirt “HYPERCENTER – USA TOUR” (limited edition) Black with Hypercenter logo in the front and USA tour dates on the back in red.	$12.00 (US)* each
	Shipping	$5.00 (US)* per item
	* US Dollars	TOTAL

I am making payment of the above total by:

PAYMENT METHOD

Please tick one:

Cheque ( ) Money Order ( )

Unfortunately we do not accept credtit card payments at this point in time.

My contact and delivery details are:

NAME	First Name		Surname
POSTAL ADDRESS	Street
	Suburb				Post Code
	City			Country
EMAIL
TELEPHONE NUMBER	Area Code	( )
DO YOU WISH TO BE ADDED TO THE HYPERCENTER MAILING LIST?						Yes ( ) No ( )

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