Ordering

Phone/fax (03) 6297 0180
International Phone/fax +(61)(3) 6297 0180
E-Mail eddie.wentorf@bigpond.com

To print this form, please right click your mouse and select print.
Fill in your order and fax it to the above fax number, or mail to
Wentorf Bronze Art Foundry, P.O. Box 8, Castle Forbes Bay, Tasmania, 7116, Australia.

Name -
Address -
City - State -
Zip - Country -
Phone - Fax -

Visa   Card Number  
Mastercard   Expiry Date  
Bankcard   Name on Card  

Ref No Qty Description

AU$
Each

AU$
Total
         
         
         
         
         
         
         
         
         
         
TOTAL  

Mastercard Bankcard Visa
Money Order and Cheque(Allow 10 days for clearance)
All prices are in Australian Dollars.