Effective Time Management Order Form

Order Form
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EffectiveTimeManagement.COM
PO Box 3260, Sunnybank South, QLD 4109, Australia
Ph. +61 7 3272 6670 Fax. +61 7 3272 4336

Name:__________________________________________________________________________
Company: ______________________________________________________________________
Address: _______________________________________________________________________
Suburb/City: __________________________________________ State: _____________________
Country: _______________________________________________________________________
Phone: _____________________________________ Fax: ______________________________
Email: ________________________________________________________________________

Order Details:
I would like to order _____ copy/copies (default is 1 if left blank) of "Effective Time Management" by Catherine Nellissen at $29.99 (US) per copy.

Payment Options (please circle the payment method you wish to use):

Bank Cheque
Money Order
Direct Deposit (please fax transaction slip)
- Bank: Commonwealth Bank of Australia
- Branch: Sunnybank Hills Branch
- Address: cnr Calam and Compton Rds, Sunnybank Hills, QLD 4109, Australia
- Account #: 064203 1008 7288
- Swift Code: CTBAAU2S
Online Credit Card Payment at http://www.effectivetimemanagement.com/order.htm
Please charge the following Credit Card (Bankcard/Visa/Mastercard only)
- Card Type: __________________________________________
- Card Holders Name: ___________________________________
- Card Number: ________________________________________
- Expiry Date: __________________________________________

Signature: ___________________________________________________
(credit card orders must be signed)

Important:
This form is confidential and intended solely for EffectiveTimeManagement.COM. If you have received this form in error, you must not use, disclose or keep this form, in any format and should destroy it immediately and notify the sender.