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Order Form
Peg's Pieces------ Order Form
Print this form out via your printer and complete the details and post with your cheque or money order (if not using charge card )
It is suggested that you set your page margins to Left 0.5
Right 0.5
Surname:
First Name:
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Address:
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Town/City:
State:
Post Code:
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Home Ph:( )
Bus/Mobile:
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| Method of Payment: [ Mastercard] [Visa]
[Bankcard] [Cheque] [Money Order] |
Card No: [ ][ ][
][ ][ ][ ][ ][ ] [
][ ][ ][ ][ ][ ][
][ ] Expiry Date: /
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Signature: |
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| Item |
Qty |
Price |
Total |
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$ |
$ |
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$ |
$ |
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$ |
$ |
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$ |
$ |
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$ |
$ |
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$ |
$ |
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$ |
$ |
Postage & Handling
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$ |
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