Mr./Ms./Mrs. Surname:
Forename:
Address:
City:
Zip:
Country:
Nearest Intl. Airport:
Phone:
Fax:
Email:
Product Detail
Item
Quantity/Total No. of pieces
Mode of Payment
Certified Bank Cheque            Credit Card
Credit Card Payment
Master Card         Visa       American Express
Card Number
Expiry
Non embossed 4 digit number at right center of the credit card above embossed numbers (AMEX card only)
Total Applicable Amount in US$
Equivalent To Indian Rupees (1$=Rs.46 Subject to change)
Signature of Card Holder :
Passport No.
Billing Address (if different than the above address)
Note: Please note that all the prices are include cost of the carpets, postage by aircraft, packing and full insurance covering all risk up to the destination.