This order form is for postal ordering. For email ordering

Keeper Order Form

This order form is for ordering The Keeper only.
To order Moon Pads and The Keeper go to Moon Pads order form. To order Natural Fertility Management Kits
To order Waterproof pads suitable for stress-incontinence or menstruation, go to Waterproof order form
To order Zappy Nappy products and Bubba Luggas for babies and infants go to Zappy order form

PLEASE NOTE THIS IS NOT AN ONLINE ORDERING SITE.
PLEASE FILL IN THE ORDER FORM, THEN PRINT IT OUT AND MAIL TO US.
DO NOT USE THIS FORM TO ORDER VIA EMAIL - PLEASE SEND A *TEXT* ONLY MESSAGE.

Your Name: Today's Date: //2008
Your Address: Town: State:
Postcode: Phone: (day); (eve)
Email:Please send me the Moon Pads eNewsletter Yes; No
I wish to pay using my credit card Visa; MasterCard; Cheque; Money Order; PayPal**
Card Number: + last three digits on reverse side Expiry Date: /
Name on credit card: Signature: ___________________________
Total of your order AUD$
Keeper cup Cost: $55.00 (includes postage in Aust; Add $5 Overseas orders) Please indicate size * : A;B
*Keeper sizes: Style A: for women after vaginal childbirth and over 30yrs; Style B: for every other woman (incl Caesarian)

 

How did you hear about us?

Payment by credit card, cheque* (*Australian bank accounts only) or money order is accepted. Please make all cheques and money orders payable to 'Moon Pads' and snail mail to: PO Box 118, SANDY BAY, Tas 7006 Australia.
Do NOT email your credit card details to me as this is not a secure site.
** To pay using PayPal first write me a text email with your details and details of the products you want. I will then invoice you by email and give you the link to make your payment securely online.

Thank you for your order and for saving our planet!

Prices subject to change without notice. Allow 2 weeks for delivery of your order. Enquiries: <info @ moonpads.com.au>

® MoonPads is the registered Trade Mark of Moon Pads ABN 47 602 059 395 <http://www.moonpads.com.au> Phone (03) 6223 5151

 

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