Brisbane Setters & Manufacturing Jewellers: Order Form

ORDER NO:

____________________________ (Office Use Only)

* If you are a first time customer, we would appreciate you completing all areas of the customer details section.
Established customers need only fill in your company name and any changes that may have occurred to your customer details.

CUSTOMER DETAILS

Name:
Company Name:
Street Address:	P'code
Postal Address:	P'code
Email Address:
Telephone:	Fax:

ORDER DETAILS

Order Date:	Contact Person:	Your Reference:
/ /
PLEASE ADVISE US IF YOU WISH TO MAKE "DIRECT DEBIT" YOUR METHOD OF PAYMENT YES NO
PLEASE NOTE, ALL CATALOGUE PRICES ARE QUOTED USING, I/SI DIAMONDS. IF YOU WISH US TO SUPPLY A DIFFERENT GRADE, PLEASE ADVISE US BY MAKING A NOTE IN THE SPECIFIC REQUEST AREA. THANK YOU.

STYLE	QTY	CARAT	COLOUR	MOUNT ONLY	SEMI MOUNT	COMPLETE	COLOUR STONE CHOICE
Eg. BS001	2	9	Y	________	________	*	Created Ruby

STYLE	QTY	CARAT	COLOUR	MOUNT ONLY	SEMI MOUNT	COMPLETE	COLOUR STONE CHOICE
01
02
03
04
05
06
07
08
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10

SPECIFIC REQUESTS

OR to +61 7 3221 0771