Throne Accessories Order Form

Please print this form and mail it to:

Throne Accessories
PO Box 1416
Fyshwick ACT 2609 Australia

or

Australia Fax: (02) 6239 1824
International Fax: 00 11 61 0 2 6239 1824

Title:	Mr Mrs Ms Miss Dr
First Name:
Last Name:
Address:
Contact Phone Number:
E-mail:
I wish to order: Finish Price: Quantity: Standard Rail Powder coated $265.00 Standard Rail Polished S/steel $295.00 Splayed Rail Powder Coated $265.00 Splayed Rail Polished S/steel $295.00 Wraparound Rail Polished S/steel $295.00 Sloped Rail Polished S/steel $295.00 Fold Down Rail Powder coated $295.00 Child’s Standard Rail Powder coated $265.00 Child’s W/around Rail   $265.00 Spacer 50mm   $110.00 Spacer 80mm   $115.00 Spacer Bracket   $36.00 Lap Sash with Buckle   $25.00 Lap Sash with Velcro   $25.00   Total   $   All price are in Australian Dollars
Payment Details: Payment by: MasterCard Visa Bankcard Cheque / Money Order Card No: Expiry Date: Amount Paid: Card Name: