Print this order form and fax it to us to place your order.
Mailing Address:
EzyDVD
P.O. Box 3138
Helensvale Town Centre
Qld, 4212
Fax: (07) 5657 7161
PLEASE NOTE: OUR DIRECT DEBIT DETAILS HAVE CHANGED. PLEASE REFER TO OUR NEW BANKING DETAILS BELOW.
Product Id
Title
Qty
Price Ex
Price Inc
Refer to web site for delivery charges.
Sub Total
Delivery
Total
NAME
STREET
SUBURB
STATE
P/C
DAYTIME PHONE
FAX
EMAIL
PAYING BY:
CREDIT CARD
DIRECT DEPOSIT
MONEY ORDER
BANK CHEQUE
Direct Deposit Note: Please use your SURNAME as a REFERENCE when a direct deposit is made. Once the deposit has been processed, please notify EzyDVD toll free on 1300 367 068. A $7.50 surcharge applies to international customers.
We no longer accept Personal Cheques, however Bank Cheques and Money Orders are still accepted.
PLEASE DEBIT MY:
MASTERCARD
VISA
BANKCARD
CARDHOLDER'S NAME
EXPIRY DATE
CARD NUMBER
SIGNATURE
Direct Deposit Details
Bank: Commonwealth Bank
Branch Name: Broadbeach
Account Name: AID - EzyDVD
Branch No: 064 450
Account No: 1033 3994