Please fill out the order form below and press the Submit button. If you are concerned about online security, your details can be given to us by telephone, fax or mail. IMPORTANT NOTE : Method of Payment - EFTPOS facilities are available at the shop. We also accept money orders and payment by Mastercard, Visa or Bankcard. We do not recommend sending credit card details by email. Credit card details should be provided by telephone, fax or mail. Cheques are accepted by prior arrangement.
Sizes: XS, SML, MED, LGE, X-LGE. GST is included. Postage & Handling is not included in pricing.
Enter the order date of: (dd/mm/yy)
Please provide the following contact information:
Name Title Organization Work Phone Home Phone FAX E-mail URL
Name
Title
Organization
Work Phone
Home Phone
FAX
E-mail
URL
You are ordering our product range of: Chilli Dance Wear
Please provide the following ordering information:
CODE/PRICE QTY SIZE COLOUR None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00 None Small Medium Large None Mauve Burgundy Black None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00 None Small Medium Large None Mauve Burgundy Black None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00 None Small Medium Large None Mauve Burgundy Black None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00 None Small Medium Large None Mauve Burgundy Black None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00 None Small Medium Large None Mauve Burgundy Black Please Note: Postage & Handling to be added to order! BILLING: Purchase Order # For wholesale purchases only! Account Name SHIP TO: OTHER COMMENTS: Street Address Address (cont.) City State Postal Code Country
CODE/PRICE
QTY
SIZE
COLOUR
None TP/B $35.00 TP/C $26.00 TP/D $35.00 TP/F $39.95 TP/G $35.00 SK/A Long $65.00 SK/A Short $48.00 SK/B Short $48.00 SK/C Long $65.00 SK/D Long $65.00 SK/D Short $45.00 SK/E Short $45.00 SK/F Short $48.00 SK/G Short $45.00 SK/H Short $45.00 SK/I Long $65.00 SK/I Short $48.00 DG/Black $125.00
None Small Medium Large
None Mauve Burgundy Black
Please Note: Postage & Handling to be added to order!
BILLING:
Purchase Order #
For wholesale purchases only!
Account Name
SHIP TO:
OTHER COMMENTS:
Street Address
Address (cont.)
City
State
Postal Code
Country