Guppytraders-Essentials Demonstration Disk - Mail Order Form

Please complete the grey areas on this Order Form and Submit or Mail it to the Address indicated at the end of this form. To ensure a swift processing of your order, please type details in all relevant sections. ( * = Required)

Name Details	*First Name : *Surname :
Address Details	*Number/Street :
	*Suburb/City :   *Code/Zip :
	*Country :
Contact No.	*Day Phone : Facsimile :
*E-mail Address

Where did you hear about this software?

* When entering Phone/Fax numbers please enter the complete International codes and prefixes.

Product	Unit Price
Demonstration CD for BodhiGold	$ 33.00 AUD*

* Australian Postage. International Postage will be charged at cost.

Paying By Credit Card  If you intend to pay with a Credit Card please complete the section below.

Select Card Type : Visa MasterCard Bankcard Credit Card Number :    CCV code :   Name on Card : Card Expiry Date : Total Amount : $ 33.00 AUD Signature :

Paying By Cheque/Money Order   Please find attached a Cheque for the sum of AUD $ 33.00   I understand, acknowledge and agree that ownership of this product will be given to me after my Cheque/Bank Draft has been cleared by the relevant financial institution.

Mailing Details   Please Mail this completed form, with the Attached Cheque/Bank Draft (if applicable) to the following Address: Roolden Pty Ltd PO Box 2059 Bendigo Delivery Centre VIC 3445 AUSTRALIA