OZSCRUBS
  PO. Box, 533
  Mt. Evelyn, 3796. Vic.
  www.ozscrubs.com
  Email: sales@ozscrubs.com
  Ph. Mob- 0410-853-919
  Ph. Mob- 0400-774-475
  Fax. No- 03-97363371
  ABN: 25 955 183 792
100% Australian made!
Use your PRINT function to print this form, esle email us and we will email it to you.

CUSTOMER ORDER FORM
Please complete the following details:
Name:
 
  Phone:
 
Address:
 
  Fax:
 
City:
 
Email Address:
 
Postcode:
 
Complete your order here / all prices include GST:
STYLE No.
Item Description
Colour
Size
Price each
Qty
Sub Total
             
             
             
             
             
Select Material Type:    
 
Embroidery Cost:    
    
100% Pre-shrunk Cotton:    
 
Postage & Handling:    
    
65% Poly / 35% Cotton:    
  
Total Value of Order:    
    

Embroidery to appear on chest pocket or same position if no pocket.
80 characters max, 2 fonts available, see sample fonts here. Costs is fixed at $????

Your Embroidery text here :---------------------------------------------------------------------------------------------------------------
Payment Details:
Visa:
 
Card NUmber:   
 
Security code on rear of Card / 3 Digits:
 
Master Card:
 
Name on Card:   
 
Bankcard:
 
Card expiry dater:   
 
Money Order:
 
Please make Cheques, payable to:   OZSCRUBS
Cheque:
 

 

Signature :___________________________
 Date :___________________

 

Forward to: OZSCRUBS PO BOX 533, Mt. Evelyn, Vic. 3796