Antiquarian Print Gallery Order form

Please PRINT this form and fill in the apropriate details, and either-

send to Antiquarian Print Gallery
148 Unley Road,
Unley, South Australia,
AUSTRALIA, 5061

Telephone the Gallery on (+61 8) 8274 1818

Fax:(+61 8) 8373 6540

Email to sandra@antiquarianprintgallery.com.au

My Payment will be (subject to exchange rates click currency converter)

Total Amount in Australian Dollars (AUD):

Required Details to receive an email Paypal Button

Name:

Country of origin

Invoice Reference Number/List of Items:

Mailing Address

E-mail to send Invoice

Name and address of recipient:
Please check all details carefully.

Items I wish to purchase:
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
4. ____________________________________________________
Other enquiries:

Required Details to receive an email Paypal Button
Name:
Country of origin
Invoice Reference Number/List of Items:
Mailing Address
E-mail to send Invoice
Name and address of recipient: