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ESSEX MINIATURES AUSTRALIA

ORDER FORM

If you wish to make an order, print out the form below, fill it in and mail it to:-

Or e-mail to essexminiatures@optusnet.com.au

                      Essex Miniatures Australia
                               22 Sydney Road
                          Hornsby Heights, 2077

CUSTOMER DETAILS:-

NAME : ___________________________________

ADDRESS : ________________________________ __________________________________________ __________________________________________ __________________________________________

ORDER:-

QTY.                CODE NO.          PRICE

_____          ___________        ___________     _____          ___________        ___________      _____          ___________        ___________   _____          ___________        ___________  

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_____          ___________        ___________ _____          ___________        ___________ _____          ___________        ___________ _____          ___________        ___________ _____          ___________        ___________ _____          ___________        ___________

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TOTAL : $________

METHOD OF PAYMENT : _____________________

CREDIT / DEBIT CARD ONLY

Card type : _______________________________

Card no. : ________________________________

Expiry date : ____ / ____

Card holders name : ________________________

         
 
  
   
 
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                                 Essex Miniatures Australia
                                                22 Sydney Road
                                        Hornsby Heights, 2077

                                        Tel: (02) 9477 6696
                                      
                                   Email: essexminiatures@optusnet.com.au
 
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