Pamper Pack Order Form

Customer Name:

Phone Number:

Email Address:

Company/Business Name (if applicable):

ABN (if applicable):

Number of Pamper Packs required:

Do you require this order to be shipped directly to the recipient? (Please note, a shipping charge will apply)

Yes please! (Please provide shipping details below)
No - please ship directly to me & I will deliver

Recipient's Name:

Recipient's Postal Address:

Occasion/Purpose:

Birthday Gift
Engagement Gift
Wedding Gift
Anniversary Gift
House-warming Gift
Thank You Gift
Christmas Gift
Bereavement/Sympathy Gift
Other (Please specify below)

Please specify for 'Other' occasion:

Please create each Pamper Pack to the value of:

Desired contents: (Please note a random choice of products will be included unless specific choices are noted below)

Candles only
Soap only
Candles & Soap
Create My Own! (Please provide a list of your desired PKM products in box below)

Please include the following items in the 'Create My Own!' Pamper Pack:

Do you require a Greetings Card to be included?

Yes please! (Please include your message in the box below)
No, thank you.

Greetings card message (if applicable):

Preferred method of contact:

Phone
Email

Best time to contact me:

Morning
Afternoon
Evening
Anytime!

Any other comments?

Thank you very much for your order! An invoice will be forwarded to your email address soon.