nekopilara order form

Order Form for
The Birth of Neko Pilara - a birthing film.

Name

Mailing address

Email address

Phone number (optional)

PAL DVD

I would like to order (type in number) of The Birth of Neko Pilara

The cost for this purchase, at NZ$75 per video is

NTSC DVD (USA)

I would like to order(type in number) of The Birth of Neko Pilara

The cost for this purchase, at NZ$75 per video is

The Total Number of videos I am ordering is(type in a number)

Please Calculate totaL cost of videos.

Please Calculate packaging & postage: within New Zealand, NZ$5 each, international, NZ$10 each.
For orders of five or more packaging and postage charges are halved.

Please add total video cost and packaging/freight cost:

Your order will be dispatched within five working days of receiving payment.

Payment

Credit card payment: click and you will be redirected to the credit card payments page.
click to start again.

Payment by cheque:
Please make cheques payable to
Golden Bay Films, and send along with a printed copy of this order to:

Jonathan Hearn,
Golden Bay Films,
Pakawau R.D.1,
Collingwood 7073
Golden Bay,
New Zealand
Telephone: -- 64 (0)3 5248040
Print this form and post it with your cheque payment; or press the "proceed to credit card payment" button for the credit card payment page.