Use this invoice to apply for a subscription to AUUGN. A different form should be used to apply for ordinary, institutional, or student membership.
To receive a subscription to AUUGN please print out this invoice, complete it, and return it to:
AUUG Incorporated
PO Box 7071 Baulkham Hills BC NSW 2153 AUSTRALIA |
Surname: _______________________ First Name: ___________________________ Title: _______________________ Position: ___________________________ Organisation: ________________________________________________________________ Address: ________________________________________________________________ Suburb: __________________________ State: ________ Postcode: _________ Telephone: Business: ________________ Private: ___________________________ Facsimile: __________________________ E-mail: ___________________________
Please tick the box to apply for a subscription. Please indicate if international air mail is required.
Renew/New* AUUGN Subscriptions |
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$125.00 (including $11.36 GST) | |
Surcharge for International Air Mail |
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$60.00 |
* Delete as appropriate.
GST applies for delivery within Australia. Rates valid from 1st July 2000.
AUUG mailing lists are sometimes made available to vendors. Please indicate whether you wish your name to be included on these lists:
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Yes |
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No |
Cheques to be made payable to AUUG Inc. Payment in Australian Dollars only.
For all overseas applications, a bank draft on an Australian bank is required.
Please do not send purchase orders.
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Please debit my credit card for A$____________ |
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Bankcard |
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Visa |
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Mastercard |
Name on Card: _________________________________________________________ Card Number: __________________________________________________________ Expiry Date: __________________________________________________________ Signature: ____________________________________________________________
Chq: bank _________ bsb _____-_____ a/c ________________ # _________________ Date: ________ $ CC type ___ V# ____________ Who: ______________ Member# __________
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