Cowley's Collectables
ORDER FORM


PLEASE FILL IN THE FORM BELOW & WE WILL CONTACT YOU FOR PAYMENT DETAILS
OR, IF YOU REQUIRE IMMEDIATE DISPATCH OF YOUR ORDER -
FILL IN THE FORM BELOW & SEND YOUR CREDIT CARD DETAILS TO
   OUR EMAIL ADDRESS :
cowleys@cowleys-motorcycles.com.au

      OR, IF YOU PREFER, BY MAIL, PHONE, OR FAX
WITH YOUR ORDER &/OR PAYMENT DETAILS

FOR YOUR CONVENIENCE A currency converter IS updated on a daily basis

(**Items marked with a * are Required Fields)**

	CONTACT DETAILS			SHIPPING
Name*				Fill in below if you wish to send to a different Address:
Street address*			Name
Address cont.			Street Address
City*			City
State/Province*			State/Province
Country*			Country
Zip/Postal code*			Zip/Post code
Home Phone*
Fax Number
E-mail*


	PRODUCT INFORMATION
Model/Product*		Qty*
Order # or Page/Photo #

ANY OTHER INFORMATION
(Make sure we know what you want - ie. Colour, or Description etc)

IF YOU HAVE ANY FURTHER QUESTIONS, PLEASE FEEL FREE TO
WITH YOUR ENQUIRY !