back                           Baggy Caps Order Form

Please print the following form.  
For prompt and efficient delivery please ensure all details are correct.

Mail it to us at:   Baggy Caps
                         PO Box 1010
                         Bibra Lake WA 6965

Customer Name _____________________________________       Date _____________

Delivery Address _________________________________________________________

 _____________________________________________     Postcode/ZIP _____________

Home Phone ______________  Work Phone _____________  Mobile _______________

Fax _______________                Email ________________________________________


                                 Item & Description                                 

 Quantity  Price
 (per unit)
   Total    
       
       
       
       
       
       
       
       
                                                                                                    * Plus Postage +  ________
                                                                                                             
                                                                                                 TOTAL (AUS $) =  ________
Payment Details

  Cheque**    Money Order      Visa Card       Mastercard       Bankcard

Credit Card Number     __ __ __ __    __ __ __ __    __ __ __ __    __ __ __ __

Cardholders Name (as shown on card) _________________________________________

Expiry Date _____________           Cardholders Signature ________________________

  *  Overseas orders please contact us for the most suitable postage option.
**  Orders by cheque should be made payable to Baggy Caps and will be dispatched after cheque has cleared.