Customer Name*:  

Residential Address:   Your order will be shipped to this address unless an alternative Shipping Address is provided below.

Street / PO Box*:  

Town / Suburb / City*:     

State*:             Postcode*:  

Country:  (if not Australia)     

Shipping Address:  Only complete this section if different from above residential address. 

Name / Company Name: 

Street / PO Box:  

Town / Suburb / City:      

 State:               Postcode:  

Country:  (if not Australia) 

Phone - Home:      Work:

Phone - Mobile:    

Email*:  

NOTE: If you do not supply an email address we will be unable to send confirmation of your order.

Please provide the Name, Breed, age and weight of each dog you are ordering for, plus any other comments that may be relevant to products you are ordering:

Please fill out all relevant information for each product you wish to order, including style, size and colour where applicable.

Additonal Product Information:  E.g.  Harness measurements, special requirements etc.

Please select payment method from menu below*:

Visa Card MasterCard Bankcard Cheque / Money Order Direct deposit  

Cheque payments:

Cheques to be made payable to: Windchill Dog Gear

Post cheques to:  Windchill Dog Gear, PO Box 41, Hurstbridge  VIC  3099, Australia

Credit Card payments:

If paying by credit card, please provide the following information:

Cardholder's Name:    

Card Billing Address:   

Card Number:               Expiry Date: /

Direct Deposit payments:

Please email us for our account details, and notify us by email when the payment has been deposited.