Stillroom Retail Fax-Back Order Form
Fax to: The Stillroom Fax Number: +61 8 9296 0705
Name:__________________________________________________________ Address: ________________________________________________________ _______________________________________________________________ Phone: _________________________________________   I wish to pay by: Visa______ Mastercard______ Bankcard_______ Card Number: __________- __________ - ___________ - _________ Card Holder's Name: _____________________________________________ Expiry Date (month/year): ____________ - _____________ Amount AUD$:_________________
CLOTHING PROTECTORS QTY Coloured Print QTY Calico/Dried Flowers       Rose and Lavender __________ __________ Lavender __________ __________ Lavender & Clove (Calico Only)   __________ Citrus (Calico Only)   __________ Lemon Scented Gum __________ __________       SHOE FRESHENERS QTY Coloured Print         Rose and Lavender __________   Lemon Scented Gum __________         ESSENTIAL OIL BLENDS QTY   (Available Australia only)       Rose and Lavender __________ Lavender __________ Lavender and Clove __________ Citrus __________ Lemon Scented Gum __________ Orange and Madarin __________   A charge for Postage/Freight will be made At Cost and you will be notified by email. Remember, a 10% discount on item prices applies when you purchase 3 or more items.