ALTERNATE WORLDS  Printable Order Form
Please print this form using the print button on your browser or email us the relevant information about your order
Title: First Name: Surname:
Address:
Country: Zip / Post Code:
Telephone: Facsimile: Cellular:
Email Address:
Delivery Address (if different to above)
Method of payment (please circle): Cheque Credit Card Direct Deposit
Mastercard Visa Bankcard American Express Diners Card
Card # : _ _ _ _- _ _ _ _ -_ _ _ _- _ _ _ _ Expiry Date: Total: $

 

Signature: ____________________________________________ Date: __________

I certify that I am 18 years or older for the purposes of ordering adult material.

Signature: __________________________________________________________
Product Code Description QTY Price
       
       
       
       
       
       
       
       
       
       

THANK YOU FOR YOUR ORDER                               PURCHASE TOTAL:$

 

 

PLEASE EMAIL FOR A QUOTE ON POSTAGE & HANDLING FOR YOUR ORDER IF YOU ARE POSTING YOUR ORDER TO US, AS P&H IS BASED ON THE WEIGHT OF THE FINAL ORDER, OTHERWISE  P&H WILL BE ADVISED via EMAIL WHEN ORDER HAS BEEN COMPILED.
 EMAIL us the relevant information about your order to aworld@labyrinth.net.au

or mail to- ALTERNATE WORLDS, P.O. BOX 1278, WINDSOR, VICTORIA,  3181 AUSTRALIA
Or Fax this form to: (03) 9529 2040 (within Australia) OR +61 3 9529 2040 (outside Australia.)