Order Form - Complete, Print and Fax
Classic Car Connections
ABN: 58 007 151 046
5 Ivon St, Bayswater
Victoria, Australia, 3153
Ph: +61 3 9729 5556
Fax: +61 3 9729 5557
www.airide.com.au
Your Details
Name
Address
Address
Phone/Mobile
Email Address
Vehicle Details
Make/Model/Year  
Engine  
Front Suspension  
Rear Suspension
Product Description Qty Price SubTotal
Freight 
Total 
Method of Payment - Cheque COD Direct Deposit Credit Card
Credit Card Details Visa Master Card Bankcard
Credit Card Number
Expiry Date /
Name on card


Authorised Signature

_______________________ Date __________________


Office use only

INV: _____________________________________