- - - - SEASIDE TOWN - - - -
Club Member No: _______
2017 Mystery button club Sign up Form To sign up for the Club, please complete this form and Email to
[email protected] Or Post to Little Quilt Store PO Box 9314, Pacific Paradise, Qld 4564 Australia Telephone: + 61 7 5450 7497
PLEASE PRINT CLEARLY Name: Address:
Telephone:
(please include country code if overseas)
Email: Credit Card Information: Name on card
________________________________________________
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Card number
! Mastercard ! Visa ! I prefer to pay via Paypal * *If using this option please supply the email address associated with your Paypal account
Cost: For pattern and either hand painted or etched raw wood button - please tick box to choose your option. See below for optional extras. Postage will be adjusted if optional extras are selected.
Optional Extras: If ordered, these items will be delivered with Month 1 of the club. Postage and handling will be adjusted accordingly. Prices are plus gst for Australian customers
Commencing:
Expiry date
_ _ /_ _
Security Code
Option 1: Pattern with hand painted button A$20.00 per month for 12 months Option 2: Pattern with etched raw wood button A$15.40 per month for 12 months
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Prices are plus gst for Australian customers. Plus postage and handling per month
A$ 5.50 within Australia A$ 8.50 to New Zealand A$10.50 to Rest of the World Fabric pack (21 assorted fabrics) $150.00 Thread pack (14 Valdani threads) $ 77.00 Seaside Town exclusive wooden thread spools – pack of 14 $ 20.00 Pre-cut water soluble 2” clamshell papers with acrylic template $ 16.50 Karen Kay Buckley Perfect Scissors - large $ 52.80 ¼” (6mm) Clover Fusible bias maker $ 13.60 Clover fusible tape (5mm x 25m) $ 17.30 Applique Paper $ 34.65 Glue Pen $ 9.90 Glen Pen refills $ 8.80 Stitchery Stabilizer (1m x 1.5m) $ 11.95 Black non-slip design mat $ 19.95 Apliquick Rods $ 49.50 Roxanne’s Glue-Baste-It (small size) $ 11.45
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April 2017 finishing March 2018
By signing up for the Seaside Town Mystery Button Club you agree to us charging your credit card the amount for your chosen option above plus postage per month for a total of 12 months, commencing April 2017, plus any additional items ordered each month. All prices are plus gst for Australian customers.
Signature
_______________________________________ Date _ _ / _ _ / _ _
Office use only: Month 1
$
Despatch dates Month 2
$
Month 3
$
Month 4
$
Month 5
$
Month 6
$
Month 7
$
Newsletter: _____ Month 8
$
Month 9
$
Month 10
$
Month 11
$
Month 12
$