CURRUIRA 42
Order Form

B & G yacht design

Mail adress:: 71 Birdwood Circus, Bicton, 6157, W.A., Austrália.
Phone/Fax:(+61) 8-9339-8236

To acquire the plans for the Curruira 42 , please print this order form, fill it in and send it to us on line, by fax or mail. The payment can be done by credit card or by a deposit in our bank account.
THE PLANS WILL BE POSTED BY EXPRESS MAIL SERVICE WITH NO ADDITIONAL COSTS.
Name:

________________________________________________________________________
Address:

________________________________________________________________________
City:

___________________________

 State:

_________________________________
Country:

___________________________

 ZIP:

________________________________

phone:

___________________________

 fax:

_________________________________
e-mail:

__________________________________________________________________
 
Choose payment form:

Deposit in account

Credit Card
 
Option 1: Deposit in account

ANZ Bank
BSB 016141
Account Number 9099 94406
Branch add. - Melville Plaza 380 Canning Highway, Melville, WA 6156
Swift Code - ANZBAU3M
date of the deposit:

_________________________________

 number of the deposit:

____________________________________
  value to be paid:
U$1250,00
Option 2: Payment by creditcard:

Visa (Id. Code:____________)

American Express (Id. Code:____________)
card number:

______________________________________

 expiration date:

_______________________________________
value to be paid:
U$ 2500,00
 signature:

______________________________________________________
WARNING
These building plans are copyrighted and its reproduction, or the reproduction of its parts by any form without the previous and written consent of the copyright owner is expressly prohibited and subject of the criminal and/or civil provisions of the Brazilian copyright laws and the international copyright treaties.

________________________________________________________

(Signature)