Printable Order Form
All prices listed are in Australian Dollars unless specifically stated
Please ship my Primal Scream package to
| Name________________________________________
Address______________________________________ City ____________________________ Postcode ________________________ Phone ( ___ ) ____ - _____ Ext _____ Email __________________________ Date ___________________________
|
|
|
|
|
| Primal Scream
Pillow
( Package includes 1 spare pillow slip, brow damper and one 100ml bottle of rosewater mist.) |
Quantity: |
|
| Custom Slip | Quantity:
( specify Leather, Velvet, PVC, Cotton) |
|
| PCV storage pouch | Quantity | $5.00
incl
GST
(After March 30 - $9.95) |
| Spare Slips
( 1 slip per pack) |
Quantity:
Custom: |
|
| Extra Bottle
of
Rose water Mist
( 100mls ) |
Quantity: |
|
| Postage and Packing
( one payment per order ) |
|
|
|
|
$ |
Simply print and fill out the order form, include your payment ( money order only) in the envelope and mail direct to us at:
KYRALEX Concepts
Pty Ltd
6 Nelson Avenue
Altona Meadows
Vic 3028
Australia
Please allow 7-10 days for delivery
Alternatively you
can utilize our direct deposit scheme and telephone us with your order
on:
Melbourne
03)
93988378 or 03) 93158892.
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| In an effort to increase awareness, a portion of the profits taken from sales of The Primal Scream Pillow will be sent to Australian Amnesty to aid in the ongoing struggle and fight against Female Genital Mutilation. |
Thankyou for your support
The Primal Scream Pillow
tm
A pain positive approach to play
Bought to you by KYRALEX Concepts,
Melbourne Australia
http://www.kyralex.ar.com.au
