C
onsolidated
R
esources for
A
mbulance
P
aramedics
Order Form
Ordering your DVD-ROM is as simple ar
A-
B-
C
- A -
Delivery Details
Your Name
Address
Town/City
State/Region
Postcode
Country
Email
Phone
Price
- B -
Your Order
e.g.
Au$ 20 / per DVD-ROM
Quantity
3
Postage
Sub-Total - at Au$20/ea
$60
Within Australia
Outside Australia
Postage - Au$
$2
Au$ 2 / per order
Au$ 5 / per order
Total - Au$
$62
- C -
Use any 1 of these 3 Payment Methods
1. Money Order/Cheque:
After filling in parts
A
and
B
of this form,
Click here
to print it
then post with your payment, payable to
John Till
to:
PO Box 364, Gisborne, Victoria, Australia 3437
2. Credit Card:
After filling in parts
A
and
B
of this form,
c
omplete the
Credit Card Authority
section below,
then click on the
"Submit Order"
button
Cardholder's Name
(as shown on the card)
Card Number
Visa
MasterCard
Expiry Date
(mm / yy)
3 Digit Code
(Last 3 numbers on the back of your card)
After "submitting" your order.
please wait for the confirmation page to appear or I may not get your order
3. PayPal:
No need to fill in this form,
simply select "Australian" or "International" order:
Australian Order: $20/DVD +$2 Postage
International Order: $20/DVD +$5 Postage