MAIL ORDER  FORM 
SIMPLY PRINT THIS PAGE OUT, COMPLETE CLEARLY, SIGN AND FAX
Please send me: (Description of item(s) Select now or fill in after printing) 
 

Total in US$:.............................................. 
Cardholder Name:
Company Name:
Cardholder Address:
City:                                                                              State/Province:
Zip Code:                                                                      Country:
Phone No:                                   Fax: No:                                    Email:
 
Amount to be charged in US$ ........................ 

Please write the amount in words ........................................................................... 
Total in US$ will appear on your statement in Thai Baht. Please allow for currency fluctuations.
ENTER YOUR CARD DETAILS  
 
CARD VALIDITY 
THRU  MTH / YR
/ 
 		  
4 DIGIT No. PRINTED ABOVE CARD No.
 
  
 WRITE CARD  NUMBER.CLEARLY 
 		  
Name as on Card:.............................................................................. 
 		  
 
Cardholder Signature: ....................................................Date:............ 
Please double-check your card details are correct. 		  
 
FAX THIS FORM AFTER COMPLETING YOUR ORDER DETAILS TO:  
In the USA:  (509) 561-6280  In the UK: (0845) 127-4926 
From other Countries International Access Code + 66 2 910 0126 
ALTERNATIVELY MAIL TO US: 
PerfumersWorld Ltd., 96/35 Prachachuen 37, Bangsue, Bangkok, Thailand. 10800. 
Or visit our showroom: PerfumersWorld, 120/1-2 Ngamwongwan Rd. Nonthaburi, Thailand. 11000. 
Allow up to 28 days for delivery
 
Other Payment Methods