Cutana Hat Company
5 Robb Street, Alstonville, 2477, Australia
Ph: (02) 6628 3331 Fax: (02) 6628 5455
INTERNATIONAL: + 61 2 66285455
Mail/Fax Form
Fill out the form. Fax or mail with cheque, money order or credit card to the address above.
Please note all prices are in Australian Dollars
Shipping Details
 Name:         Address:  
 City:  State/Prov:  Post Code/Zip:
 Country:  Phone No:  Fax No:
 Email Address:  Website:
Hat / Ugg Boot

*Size

Colour
Price
Quantity
S/Total

A. Cost of Hats:
B. Australian residents
add 10
% GST:
C. Postage & Handling:
See page 2 for costs
Sub Total (A+B+C):
D. Insurance: Most Important
See Below
Total:

Insurance
Up to $99
$9.80
$100 - $199
$12.30
$200 - $299
$14.80
$300 - $399
$17.30
$400 - $499
$19.80

Postage and Handling

Cutana Hats
Helmet Shades and Croc Bands
Amount
Ordered

Australian
P&H Charges

International
P&H Charges
1
$15.00
$37.00
2
$23.00
$52.00
3
$31.00
$72.00
4
$39.00
$92.00
5
$74.00
$112.00
Sub Total: Please add to box C on page 1
Amount
Ordered

Australian
P&H Charges

International
P&H Charges
1
$9.50
$22.00
2
$12.75
$30.00
3
$16.00
$38.00
4
$19.25
$47.00
5
$22.50
$56.00
Sub Total: Please add to box C on page 1

Braids, Gumnuts and Kangaroo Lacing
Cutana Ugg Boots
Amount
Ordered

Australian
P&H Charges

International
P&H Charges
1
$9.50
$20.00
2
$12.75
$26.00
3
$16.00
$32.00
4
$19.25
$38.00
5
$22.50
$44.00
Sub Total: Please add to box C on page 1
Amount
Ordered

Australian
P&H Charges

International
P&H Charges
1
$15.00
$32.00
2
$23.00
$52.00
3
$31.00
$72.00
4
$39.00
$92.00
5
$74.00
$112.00
Sub Total: Please add to box C on page 1

Payment Method (Please select one)
Cheque or Postal Order: $
Master Card Visa Diners Club American Express
Credit Card Number
Expiry Date
American Express ID Number
Signature:

FINDING THIS FORM A BIT TOO CONFUSING? PLEASE CONTACT ME ON
Ph: (02) 6628 3331   Fax: (02) 6628 5455  International Ph: + 61 2 6628 3331
E-mail: cutana@cutana.com.au   


Please allow the following shipping times: 8 - 14 days.

For Individual Attention or Wholesale Enquiries Contact
Jack Cunningham
Website: www.cutana.com.au