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Mail/Fax Form Fill out the form. Fax or mail with cheque, money order or credit card to the address above. Please note all prices are in Australian Dollars |
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Shipping Details |
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| Name: | Address: | ||
| City: | State/Prov: | Post Code/Zip: | |
| Country: | Phone No: | Fax No: | |
| Email Address: | Website: | ||
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Hat / Ugg Boot |
*Size |
Colour |
Price |
Quantity |
S/Total |
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A. Cost of Hats: |
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B. Australian residents add 10 % GST: |
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C. Postage & Handling: See page 2 for costs |
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Sub Total (A+B+C): |
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D. Insurance: Most Important See Below |
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Total: |
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Postage and Handling
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Cutana Hats |
Cutana Belts Caps, Helmet Shades |
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Sub Total:
Please add to box C on page 1
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Braids, Croc Bands, Gumnuts, Kangaroo Lacing |
Cutana Ugg Boots |
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Sub Total:
Please add to box C on page 1 |
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Payment Method (Please select one) |
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Cheque or Postal Order: $ |
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Master Card
Visa
Diners Club
American Express |
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Credit Card Number |
Expiry Date |
American Express ID Number |
| Signature: | ||

For Individual Attention or Wholesale Enquiries Contact
Jack Cunningham
Website: www.cutana.com.au