| Surface mail only Australia $25.00 Overseas $30.00 AUD - 4 editions issued per year |
Name/Organisation |
Address |
Postcode |
Day Telephone Number |
Contact Name (if Organisation) |
Contact's Job Title (if Organisation) |
Section (if Organisation) |
SIGNATURE: DATE: |
I / We wish to pay by: Cheque / Cash / Money Order
OR Bankcard / Mastercard / Visacard
Card Number: |___|___|___|___| |___|___|___|___| |___|___|___|___| |___|___|___|___|
Expiry Date: _________ / _________
Amount: $A_____________________ Signed: ______________________________