Order Form - Ausight

Order Form

We have 3 different payment methods available: Credit Card (recommended), Wire Transfer and Check.
　

For Details in relation to the secured on line Credit Card payment, please visit Payment Methods.

　
If you choose to pay by Wire Transfer or Check, Please fill in the information below and fax the completed form to
0061 2 9897 3690 or email to accountant@ausight.com.au. If you have any questions, please feel free to contact us at accountant@ausight.com.au.

　
Order information

Directory name: ____________________________________

____________________________________

____________________________________

Order Number:

(optional)
____________________________________

Please enter the quantity of the report format you require.

Format Quantity Price

Electronic _________

Contact information

Please enter all the information below in BLOCK CAPITALS.

Title: Mr Mrs Miss Ms

First name: Last name:

Email address:

Job title:

Organisation:

Address:

City:

Postal / Zip code:

Country:

Phone number:

Fax number:

Payment information

Please indicate the payment method you would like to use by selecting the appropriate box.

Pay by check:

Please post the check, accompanied by this form, to:

Ausight Publishing

4/26 Military Road

Merrylands NSW 2160

Australia

Pay by wire transfer:

Please transfer funds to:

Account number: 082-057 58-841-4908

Swift code: NATAAU3302S

Bank Address:
National Australia Bank

255 George Street

Sydney NSW 2000

Australia

If you have a Marketing Code please enter it below:

Promotion Code:

Please fax this form to 0061 2 9897 3690

　

　

　

　