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This transaction is for purchases on or off the www.australiatrade.com.au web site
Payment to go to Celestial Industries Pty Ltd acn no: 050.405.377
Registered in the State of Queensland: Country of Australia

Name of Customer
( Purchaser of Goods )
Please advise what product or service you wish to purchase 
If you wish to take out advertising on our Bulletin boards or Radio stations use this form
If you want goods sent to you please advise your address on this form
Country and Post / Zip code
Payment in Trade Terms Payment By Card Type Card Expiry Date
Name of Bank that Issued Card
Country Where Card Issued
Purchase Price of Product Invoice
Shipping / Postage & Handling Invoice
Total Invoice Amount
Card Holder's Name
Card Number
Your Card should contain 16 numbers
( example only )
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Signature:

Name : 
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