ANSA - SOUTH AUSTRALIA
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ANSAWARE ORDER FORM

Item Cost per Item No Ordered Total Cost
ANSA Boat sticker  Type 1 (check pictures) $3.50    
ANSA Boat sticker  Type 2 (check pictures) $3.50    
ANSA Car sticker pair $3.00    
ANSA Car sticker reverse pair $3.00    
ANSA Metal lapel badge $4.00    
ANSA Cloth badge $7.00    
ANSA Cap (yellow with badge) $15.00  

     

Packing and Postage $3.00   $3.00
Postal note or cheque enclosed   TOTAL DUE

      $

Delivery address
 

Deliver to  
NAME  
Street  
Town/City  
Postcode  

Invoice to the following if cheque is not included.

Invoice to  
NAME  
Street  
Town/City  
Postcode  

NOTE the reverse sticker goes inside of window glass, normal sticker goes on the outside of any surface.

Mail to:     Membership Director
                  ANSA Ware
                  PO BOX 328
                  MATRAVILLE NSW 2036
 
Fax to: (02) 96619297