ORDER FORM:

[FrontPage Save Results Componeent]ORDER Request Form - TASMANIA SHOP & GALLERY

Please fill in ALL fields listed BELOW!

PRODUCT CODE:
DESCRIPTION:
QTY
COMMENTS
CREDIT CARD TYPE Visa Mastercard AMEX Diners Bankcard 

NAME ON CREDIT CARD
CREDIT CARD NUMBER
EXPIRY DATE
CONFIRMATION NUMBER
(FOR CONFIRMATION NUMBER turn your card over and enter the last 3 DIGITS of the numbers underneath your signatory)

Tell us how to get in touch with you:

Please note additional freight charges will apply for all stock items. 

Name
Title
Company
Address
E-mail

Website

Fax
Phone

THANK YOU FOR YOUR ORDER!!  

Please enter your comments in the space provided below and any feedback or suggestions you may have in respect to this site!!

Please note delivery charges are extra and will be charged to the purchasers credit card.  If you would like to no what the delivery charges are for you order and what the estimated time of delivery is then please check this box  

If you also require freight insurance on your order please check this box.  This cost is paid by the purchaser.  As no replacement will be given for damaged or missing goods without the appropriate claim forms for freight insurance!!

Please check this box to be added to our email mailing list!

Please check this box to add a link to your site on www.tasinternet.com, www.tassearch.com, www.tasdirectory.com, www.tasgifts.com and many more!! THIS IS A FREE SERVICE conditions apply!!!

PLEASE ALLOW 7 DAYS REPLY ON ORDER.  Thank you.  (Otherwise please check this box for urgent confirmation of order!

 

 
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