Page 1

1. A or B

6.

2.

3.

7.

8.

4.

5.

9.

10 A or B

Cod 1A 1B 2 3 4 5 6 7 8 9 10A 10B

Product 2006 Official Climatecool 2006 Official Argentine Official Goalkeeper Cotton shirt Cotton shirt Cotton shirt Cotton shirt Cotton shirt Cotton shirt Official shorts Shorts

Au$

P&H Au$

147 97 97 97 30 30 30 30 30 30 54 34

15 15 15 15 15 15 15 15 15 15 15 15

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Personal Details Name/Surname Phone: E-mail: Address: City: Suburb: Postcode: Product Number

S

M

L

XL

Price

QTY

Total

PLEASE MAIL COMPLETED FORM TO EITHER: riverplateaustralia@hotmail.com PO Box 79 Olinda, Victoria 3788 Cheques and money orders should be stapled to this form Remember to add you POSTAGE & HANDLE ING (P&H)

VISA

M/C

B/C

AMEX

DINERS

CHEQUE (Make payable to River Plate Academy Australia)

Card Number Card holders name ( Please print)

Expiry Date /

Total

Card holders signature

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