SAME DAY EXPRESS Delivery to Metro Sydney | NEXT DAY Australia Wide More Info

LOVE LIST
Please Login First
Shopping Cart 0

You have no items in your shopping cart.

Order by fax

 

To order by FAX, you can print out the form below and FAX the completed form to us.

(Note: you can also fill in the form by TYPING directly into the fields below, and then print it to fax it).

Your details
Full name:
Company name:
Address:
Contact Phone:
Contact Email:
   
Hamper details
Gift Hamper Name:
Gift Hamper Price:
Quantity
Gift Tag message
   
Recipient's details
Recipient's name:
Recipient's Company:
Recipient's Contact Phone:
Delivery Address
(street, suburb, state,
postcode):
Delivery Area/Cost:
(Please tick one)
Sydney Metro ($9.95) NSW ($14.95)
ACT ($14.95) VIC Melbourne ($14.95)
VIC outside Melbourne city ($14.95) QLD Brisbane ($14.95)
QLD outside Brisbane city ($14.95) SA and TAS ($14.95)
NT and WA ($14.95)  
Preferred Delivery Date:
(all efforts made to accomodate)
Special Instructions:
If there is nobody home to receive the package, do you give permission for it to be left at the door?
Yes, permission to leave at door No, do not leave package unattended
   
Credit Card information
Credit Card Number:
Name on card:
Expiry Date
CCV Number:
(The last 3 digits on the back of the card)