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Designer Lights
Order Form

Please select items on the products pages to add to the cart, then return to this page to complete your order.

Name  
Delivery Address  
Suburb/City  
State  
Postcode  
Phone  
Email  
Delivery Instructions

 
Please do NOT send your credit card details with this order. We will contact you by telephone as soon as possible to confirm product availability and payment.

If you prefer, complete the section above and print the form, write the transaction amount and your credit card details in the section below and sign, or enclose a cheque.

Post your order to:

Designer Lights
129 Barrenjoey Road
MONA VALE NSW 2103

or fax your order to:

(02) 9979 5633

 
Transaction Amount $ _________________   
Credit Card # _____________________________  Expiry ___ / ___  
VisaMastercard Bankcard American Express  
Name on Card ____________________________   
Signature ________________________________   
   
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