Carol & David Arnold
Mail to:- Carol & David Arnold Coober Pedy Opal.com Hopeful Hills Coober Pedy South Aust 5723 Australia	Or fax to:-  +61 8 8672 5313
To place an order with Coober Pedy Opal.com, simply print this page, fill out the order form and mail or fax it, with payment/details, to us at the address above. Please see terms and conditions for payment details. If you include your e-mail address we will notify you by e-mail on receipt of your order and upon dispatch of your order. Be sure to fill out the the delivery instructions at the bottom of this form. Please note that all prices are American Dollars, and includes postage by Economy Air.

Item Ref#:	Decription:	Price:
Total Amount:

Payment Details:
Check [ ] please make checks payable to Coober Pedy Opal.com
Bank Card [ ]	Visa [ ]	Master Card [ ]
Card #		Expiration date:
Name shown on card:
Contact ph:		E-mail:
Signature:

Ship To:
Name:
Address:
City:	State:
Zip:	Country:

Return to previous page.