Acupuncture Australia Logo

On-line Order Form


 


Acupuncture
Australia

 

	Option 1: Simply fill in the delivery details, item number & quantity, then submit 
		  the form. Prices and calculations will be shown on your tax invoice. 
	
	Option 2: Fill in all the fields including prices and the total, then submit the form.


	Note:	(1) Fields marked with *  must be filled in.
		(2) The other fields are optional.



Delivery Cost



Payment Details



Contact Support


  Fields with * must be filled
Name/Company:
Shipping and
Billing Address:		 *Street:
*Suburb:
*State: *Post Code:
Order Number: Date:
Contact Details: *Email Address:
*Contact Name:
*Phone Number: For verification & credit card payment.
Fax Number:
*Item No. Description *Quantity Unit Price
(GST exclusive)		 Amount
Cost of Goods (excluding GST):
Delivery Cost (excluding GST):
Total (excluding GST):
Australian Order add 10% GST:
Total Payable:
  Comments:
  

  Standard Delivery Cost  
 
  
   Flat fee of $13.20 (inc. GST) to anywhere in Australia.
 
   Please click "Delivery Cost" for more information on freight charges.


  Payment for On-line Order  
 
   If paying on-line order by credit card, please call us during business hours or we'll contact you on the
   phone number provided
 
   Please note purchases by the general public or overseas customers must be paid in advance.
 
   Please click "Payment Details" for more information on making a payment.
 


  *Please indicate your preferred method of payment:
 
Cheque/Money Order (Practitioners only)
Credit Card (You are required to enter card details after clicking Send Order)
EFT/Direct Deposit