Travel Agent Name & ID (If Applicable):

Full Name*:

Phone Number:

Email*:

Date of Travel:
- January February March April May June July August September October November December Unsure - 2007 2008 2009

Destination:
Singapore
Kuala Lumpur
Hong Kong
Bangkok
Other: Please Specify

Number of Travellers:
- 2 3 4 5 6 7 8 9 10

Number of Days for Shopping Tour:
- 1 2 3 4 5 6 7

Number of Freight Boxes per Traveller (Box dimensions: 45*41*33cm):
- 1 2 3 4 5 6 7 8 9 10

Address in Australia for Delivery of Goods:
State: - ACT NSW NT QLD SA TAS VIC WA Town/Suburb:

Type of goods to be purchased:

How you heard about us:

Additional Information: