Barka Parka bean beds
Online Order form

**Please do not submit your Credit card or account details via this form**
Submit your details and the items you wish to order. We will contact you by
phone within 24hours to confirm your order and to obtain your payment details.
Fields marked with * must be filled in.
PERSONAL DETAILS
First name:*
Last name:*
Email address:*

CONTACT DETAILS
Home Phone:*
Work phone:
Mobile:

BILLING ADDRESS
Address Line 1:*
Delivery address (if different):
Address Line 2:
City/suburb:*
State:*
 Postcode:*

Country (if outside Australia):

ITEMS YOU WOULD LIKE TO ORDER
PET BED SETS: Use a new line to order different types of sets

Qty:
 Type of set
Size
Top Colour
Side Colour
Piping Colour
Super Set only:
Select your colours for second Slip-cover 
I would like my bed:
Filled 
Unfilled (FIY)
 Please note: Sizes 55, 58 & 58Plus can only
be sent as Unfilled sets to Country Victoria, Interstate and Overseas.

Qty:
 Type of set
Size
Top Colour
Side Colour
Piping Colour
Super Set only:
Select your colours for second Slip-cover 
I would like my bed:
Filled
Unfilled (FIY)
 Please note: Sizes 55, 58 & 58Plus can only
be sent as Unfilled sets to Country Victoria, Interstate and Overseas.

Qty:
 Type of set
Size
Top Colour
Side Colour
Piping Colour
Super Set only:
Select your colours for second Slip-cover 
I would like my bed:
Filled
Unfilled (FIY)
 Please note: Sizes 55, 58 & 58Plus can only
be sent as Unfilled sets to Country Victoria, Interstate and Overseas.

SPARE SLIP-COVERS:
Qty:
 Type of cover
Size
Top Colour
Side Colour
Piping Colour
Qty: Type of cover
Size
Top Colour
Side Colour
Piping Colour

DRI-TOP PROTECTOR:

Qty:
Size
Colour
 Please note: The Dri-top is recommended only
for incontinent pets or bitches in season.
Not intended for continuous general use.

ACCESSORIES:


Throwovers: Qty:
 Size
 Choose Colour
  Please note:
Available in
SINGLE colour only.
Lap rugs: Qty:
 Size
 Choose Colour

PAYMENT METHOD
Credit cardWe accept Visa MC
For your security please DO NOT submit your
Cedit Card details with this order form.
We will call you to take your credit card details.
Please ensure you have given us a contact phone no.
Cheque or Money order
Please make all Cheques and Money orders payable to: Barka Parka
 Mail to: 1100 Stud Road, Rowville, Victoria 3178, Australia

Please ensure you include a contact phone # and/or email address as we will contact you within 24hrs to confirm receiving your order.
Direct debit
You can deposit payment directly into our account or via internet banking.
We will email you an invoice with order details and amount due.
Please include your Last name and initial as your payment Reference. e.g. Kara Duncan = DUNCANK
Our bank details are as follows:
BANK: Bendigo
 ACCOUNT NAME: Barka Parka
 BSB No.: 633-000
 ACCOUNT No.: 119586360
What is PayPal?
PayPal
We are an authorised PayPal Merchant.
PayPal lets you pay by Visa, MasterCard or Bank deposit.
 PayPal is a secure site where you can pay for your order without having to give us your credit card or bank details.
You do not need a PayPal account. Click on the Paypal logo for details.
We will email you an invoice which will include a link to the PayPal site.
Once your payment has been received we will email you a confirmation.

PLEASE TELL US ABOUT YOUR PETS
Pet 1 Breed Pet's name Weight Length Age Sex
MF

Pet 2 MF

Pet 3 MF

Pet 4 MF

HOW DID YOU HEAR ABOUT US?
Completion of this section is optional. Multiple sources can be selected.
The information supplied will assist us greatly to assess our advertising efforts.
Thankyou for your assistance.
Magazine
 		Search engine
Website - please specify
Recommendation - Please specify who!
 Other - Please specify

ANY SPECIAL INSTRUCTIONS OR COMMENTS
Optional notes and/or comments:
This completes your order. We will contact you within 24 hrs to confirm your order and take your payment details. Thank you for choosing Barka Parka products for your pet.
Regards Kara and Simon