Name: ______________________________________
Address: ____________________________________
City/Suburb: _________________________________
State: ______________
Postcode: ___________
Complete Order:
(Please tick items and enter details on right)
WHO IS PROUSTY? | WHERE'S PROUSTY BEEN? | CORPORATE BOOKINGS | SCHOOL BOOKINGS | PHOTO GALLERY | CORNER SHOP | CONTACT US | LINKS
Total number of Items:_____
Total Cost of Items: $________
Shipping(within Australia):
Total Cost of order + Postage and Handling: $__________
Print and post this form with your
Cheque or Money order to:
David Proust
33 Boos Road
Forresters Beach NSW 2260
*Cheques made payable to David Proust
CD: ___
Prousty A-Live :___
Number: ____
$20 each
Total: $__________
Prousty Still A-Live:___
Number: ____
$20each
Total: $__________
--------------------------------------------------------------
DVD:___
Prousty Still A-Live :___
Number: ___
$25 each
total:$__________
-----------------------------------------------------------------------------------
Singlet: ___
Colour:BLUE | GREEN | RED | PINK | ORANGE
Size:_________
Number:_____
$20 each
Total: $__________
--------------------------------------------------------------
Stubbie Cooler:___
Colour: RED | BLUE | BLACK
Number : _____
$10 each
Total:$__________