MERCHANDISE MAIL ORDER FORM - HERITAGE JUMPERS

Name:

 

Delivery Address:

 
Customer Phone (Bh)  

Postcode:

 
Customer Phone (Ah)  
 

 

No.

Price

Total

I would like to place an order for these jumpers. I understand that these jumpers are made to order and will not be available for one to two weeks, depending on orders on hand:      

FITZROY FOOTBALL CLUB JUMPERS Pre 1975

     

Long Sleeve (Please indicate your preferred chest size: 95, 100, 105, 110, 115)

 

$80.00

$

Sleeveess (Please indicate your preferred chest size: 95, 100, 105, 110, 115)

 

$75.00

$

Postage & Packaging: Jumpers   $10.00  

Cheque / Credit Card
(made payable to Fitzroy Football Club Ltd.)

 

 

$

PLEASE RETURN THIS FORM WITH YOUR PAYMENT

   

I wish to use a cheque*/credit card* to pay this invoice
*delete whichever is inappropriate

Please Charge

$

Card Expiry Date:

/

Card Holder's Name:  

Card Number:

       

-

       

-

       

-

         

BankCard

Visa
AMEX
 MasterCard
 

Signature:

   

Mail direct to:
Fitzroy Football Club, suite 7 463 Main Street, Mordialloc VIC 3195
(Allow 7 days for delivery)

Or, Fax to: (61) 03 9587 0730