POSTAL ORDER FORM
(30-day money back guarantee)
WITHIN AUSTRALIA -$AUD23.00 per set (chq/EFT/money order). Orders 4+ - $AUD20.00, orders 10+ - $AUD18.00 - these prices include postage/handling. (Special rates apply for bulk orders of 25+ prs).
INTERNATIONAL CUSTOMERS - We employ PAYPAL for our online credit card processing (cost per pair is $AUD28.00). It's featured with the latest technology and world class security to make sure you have a safe and pleasant ordering experience. Please email details of your order to ultracushion@smartchat.net.au

Please PRINT out this order form, fill in details & post to address below:
 

Name:

Address:

State/Country/Post Code:

Phone Numer/Fax Number/E-mail:

Place number of 'sets of insoles' required next to the correct size/s & thickness in box/es below:

Please note: We can also provide a 'special cut' insole for people with "ACUTE" ball-of-the-foot pain - please contact us for details/cost.
Mens/11mm
5-6__
7-8__
9-10__
11-12__
Mens/7mm
5-6__
7-8__
9-10__
11-12__
Ladies/11mm
5-8__
9-10__
11-12__
13-14__
Ladies/7mm
5-8__
9-10__
11-12__
13-14__
ULTRA CUSHION INSOLES
17 Tingara Court, Tewantin, Qld 4565 AUSTRALIA
Ph/Fax: 07-5491 2176 / International: 61-7-5491 2176
(Trade enquiries welcome)

ultracushion@smartchat.net.au