Print and Digital Image Order Form
Please Print this Order Form, then mail it with a cheque to the address below.    Thank you.
Direct Debit: Our banking details or available on request for direct debit.
Name:
Mailing Address:
City:
State:
Country:
Postcode:
E-mail Address:
Phone:


Image Number Type of Print Quantity Cost
       
       
       
       
       
       
Postage $5.00
Total Cost  


Format Price
A4 - single image $15.00
A4 - two images $15.00
A4 - four images $15.00



Please Print this form and:

Mail to: Pictorial Forbes, c/o Forbes Museum, Forbes, NSW, Australia, 2871, or
Tel: +61 2 6851 6600 during Museum opening hours 2pm to 4pm ASET
Thank you.
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