"SEEING RELATIVITY" ORDER FORM
Currently the only format available is DVD/PAL, suitable for Europe, not North America)
ATTENTION DR. CRAIG SAVAGE / ANTONY SEARLE
Print out, complete and fax this form to: (02) 6125 0741 (Australian orders) OR 61 2 6125 0741 (International orders)
Contact Details:
| Name | ________________________________ |
| Postal Address | ________________________________ |
| ________________________________ | |
| ________________________________ | |
| Organisation | ________________________________ |
| E-mail (if available) | ________________________________ |
| Telephone | ________________________________ |
| Fax | ________________________________ |
Credit Card Details (Only VISA, Mastercard, Bankcard are acceptable):
| Credit Card Number | ________ ________ ________ _______ |
| Expiry Date | __ __ / __ __ |
| Name on Credit Card | ________________________________ |
| Card Type (eg VISA) | ________________________________ |
Order Details:
| Video Format:
DVD/PAL
(Australia / Europe)
|
| Quantity: AUD$50 x ____ |
| Total: AUD$ _________ |
END