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Reference #	Description	Colour	Quanity	Unit Price	Total









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Payment Details

Name:

Delivery Address:

Telephone: Fax:

Email:

I wish to pay by:
Cheque (made payable to "Bonsai Boutique" NZ only)
Bankcard
Mastercard
Visa

Card No: Expiry date:

Card holders name:

To place your order, please print out the above and post or fax.to:

Bonsai Boutique
Dean and Susan Hastie
PO Box 9113
Tauranga
New Zealand

Phone/ Fax +64 7 5784 854

To email your order please include all information requested above.
For security reasons you may wish to phone/fax us your credit card details separately.

Thank you for your order

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