Hawker Art Exhibition Faxform

FAX ORDER FORM
To:Hawker Art Exhibition - Fax number: +61 8 8648 4283
From:
Name:	____________________________________
Postal address:	____________________________________
	___________________________PostCode_________
Telephone:	_____________________
Facsimile:	_____________________
Email:


I wish to purchase the following painting(s). I have read and agree with the conditions of sale.
NUMBER	ARTIST	TITLE	PRICE	FRT/INS
_______	_______________	_________________________	_______	______
_______	_______________	_________________________	_______	______
_______	_______________	_________________________	_______	______


CREDIT CARD DETAILS: We accept Bankcard, Visa, American Express, Diners Club, Mastercard
Card type		______________________
Name on card		______________________
Card number		______________________
Expiry date		______________________
Amount of purchase (inc freight)		$ ________
Signature		_______________________