Order by Cheque or Money Order
Title(please circle) Mr Mrs Miss Ms Dr
Firstname______________Surname_____________________________________
Address___________________________________________________________
___________________State_______________Postcode____________________
Tel:Home_____________Work_____________Mobile______________________
Please tick the product(s) you would like to order
CD Title
View Product
Price
Please tick
 
Dawn
$29.95 AUD
Alien Landscape Uno
$29.95 AUD

Alien Landscape Duo

$29.95 AUD
An Alien Oddessy
$29.95 AUD
The Pheonix Trilogy
$29.95 AUD
Expressions of ET Contact - 1 - Soundtrack
$29.95 AUD
Expressions of ET Contact - 2 - Soundtrack
$29.95 AUD
Inner Alchemy - Connecting to your Spirit Guide
$29.95 AUD
Inner Alchemy - Exploring Past Lives
$29.95 AUD
Inner Alchemy - Connecting To Higher Consciousness
$29.95 AUD
Inner Alchemy - Detox
$29.95 AUD
Inner Alchemy - Inner Healer
$29.95 AUD
Artwork Order Form
Title Of Artwork
View Product
Print Size
Price
Quantity
Universal
40*40 cms
$29.95 AUD
Sense
40*40 cms
$29.95 AUD
Fluidity
40*40 cms
$29.95 AUD
Peace
40*40 cms
$29.95 AUD
Organism
40*40 cms
$29.95 AUD
 
Plus postage
$8.95 AUD
Total Value of Order
$____.00
Method of payment (please circle) Cheque / Money Order / Credit Card
Credit Card Details
Type of Card(please circle) Amex / Diners / Bankcard / Mastercard / Visa
Card Number_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expirary date_ _ / _ _
Name on Card_____________________________________________
I authorize David Sandercock to charge my credit card, as detailed above, the sum of
$__________, once only, upon dispatch of ordered goods.
Signature________________________________________
To pay by cheque or money order print out form and send.
All orders should be sent a payable to:
David Sandercock Email: Piano@globaldial.com.au
30 Brassey Street Phone 08 9 3841661
Swanbourne 6010
W.A. Australia
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