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1/22
New Street, Nerang,
Qld, 4211, Australia. Fax 07 5578 3946 |
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| Make
cheque payable to and mail to: Guitar World Queensland Pty Ltd. 1/22 New Street, Nerang, Gold Coast Qld 4211 Australia. |
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| Freight (contact us for of freight costs) | |
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| Credit Card Surcharge (4% Amex - 5% Diners) | |
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| Total (All prices include GST) | |
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Payment
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Security
ID:
(3-digit number printed on the card) |
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Card Number:
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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ | Expiry
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Name
on Card:
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Issuing
Bank:
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a)
I wish to use my ______________________ (write in name of card
here) to pay for the above goods supplied by Guitar World.
b) I hereby authorise Guitar World to debit my account with the amount specified above. c)
I Acknowledge that I have read and agree to the terms and conditions
and that Guitar World remains the sole owner of
goods described in the above and title will not pass until the total
of the authorised charges above have been paid in full.
All terms and conditions are governed by the laws of the state of Queensland. |
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Cardholders
signature:___________________________ Date:____________
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 * Please
scan or photo copy your credit card and one other form of identification.
eg. drivers license, passport. (you must copy the front and back
of your cards, and they must be legible).*
Please print out this form and send it to us by fax, email or post
after
it is completed.
*Your
personal details will remain private and confidential and will
not be used for any purpose other than
the processing of this order.
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