http://www.ostrich.com          USA Order Form             steve@ostrich.com
Tel +1 708 345 7989                                       Fax +1 708 345 8584

Send this completed order form and make out all cheques and money orders to:
ostrich.com
119 N 10th Ave
Melrose Park  IL  USA  60160
Tel +1 708 345 7989   Fax +1 708 345 8584  or email to     steve@ostrich.com

Name & Company: _____________________________________________________________

Address: ____________________________ City: _________________________________

State: ____________  Zip: _________________  Country: _______________________

Tel: _______________________________ Fax: ___________________________________

Email: ______________________________________________________________________

Credit card number: _________________________________________________________

Exp date: ____________________  Security digits: ____________________________

I authorise ostrich.com to make the appropriate charges for the merchandise
listed below, plus shipping and handling. I confirm I have read, understand
and accept the the terms and conditions of this order. Minimum order is $20
plus shipping and handling.

Signature: _______________________________  Date: ___________________________

Qty  Product Description             Colour Size Pack       Price       Total

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                                              Shipping & Handling: $_________

                                                            Total: $_________

Comments, notes or alternative delivery address:

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