ADVENTURER MAPS ORDER FORM

Adventurer Maps ( Paoletti's Maps & Videos P/L )

15 Nirvana Close, Langwarrin South. 3911. Victoria. Australia.

Tel: (61) 03 9789 6985 Fax: (61) 03 9776 6798 Mobile: 0428 534 102

Email: info@adventurermaps.com.au Prop: Rudi Paoletti

Please provide the following order information: (You may also print this form off your browser and fax/post it)

*NOTE: Some books have additional postage costs to be added.....I will adjust this price for you. I will not charge you more than $10 postage in total per order if this is the case.

First Name

Last Name

Contact Phone

E-mail

Do you want to join my Incorporation and go on our expeditions?

YES

Please provide the following ordering information: (ALL PRICES INC. GST AND POSTAGE)

QTY
DESCRIPTION
QTY
DESCRIPTION

TOTAL $

BILLING

Credit Card Number

Mastercard or Visa Only Exp. Date: /

Account Name

Credit Card:YES Direct Debit:YES Cheque:YES Money Order:YES

Direct Debit Details

Westpac
BSB: 033 138

Account #: 136 980

Account Name: Paoletti's Maps

SHIPPING DETAILS

Street Address

City State

Postcode
Country if not Australia

Additional Comments

BILLING
Credit Card Number		Mastercard or Visa Only Exp. Date: /
Account Name

Credit Card:YES Direct Debit:YES Cheque:YES Money Order:YES

Direct Debit Details
Westpac	BSB: 033 138	Account #: 136 980	Account Name: Paoletti's Maps

SHIPPING DETAILS
Street Address
City	State
Postcode	Country if not Australia
Additional Comments