Cheboom : For all your Wedding Accessories

Order Form

If You are paying by Credit Card, simply fill out the form and hit the Submit Button

If you are paying by Cheque, money order or do not want your credit card details posted through the internet,

simply complete the form online or print and complete manually. Then post it to us along with your cheque, money order

or Credit card details to:

Cheboom, Shop 2, 161 Wentworth Street Port Kembla NSW 2505 Fax: o2 4274 0599

Name
Street (no deliveries to PO Box)
Town / Suburb
Postcode
State
Phone No
Email Address
Credit Card No (16 digits)
Expiry Date E.g. May 2006 is 05/06
Card Type
Credit Card 3 digit CCV no (on back of card)
Payment B y
VIP Number ( if applicable)

Order Details

Qty	Item	Size	Colour	Description ie. tiara, necklace etc	Price	Sub-Total





					Postage
					Total

All prices are in Australian Dollars only (AUD) and include GST.