BOXER ASSOCIATION OF VICTORIA Inc.
ABN 24 240 701 423   Incorporation Registration A00 18959H
Book Order Form

"HISTORY OF BOXERS IN VICTORIA"
1947 to 2004

LEATHER BOUND EDITION
Name: ........................................................................................................

Postal Address:........................................................................................

................................................................................... Postcode...............

Telephone:....................... E-mail:...........................................................

[     ]   Number of books required @$200 per book plus P&H* ~
[     ]   I have enclosed my cheque/postal order
[     ]   I have attached my Credit Card details


* Postage Rates: Australia ..$8.90   New Zealand ..$26
UK, Canada & USA ..$32 Seamail & $50 Airmail
(Please email if unsure of rate to your destination)

~NB: All prices are in Australian Dollars.

[     ]   Tick here if collecting book personally.
(Book will be available for collection at our Championship Show or another show by prior arrangement)
Credit Card Payments

Credit Card No: [     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ][     ]

Card Type: .......................................

Name on Card (Please Print):............................................................................. 

Expiry Date on Card:......................   Payment: $......................

Signature...........................................................   Date......................


Please Mail this form with your cheque or money order to the address at the bottom of this form
(or by Fax if including credit card details)

To: The Secretary,
PO Box 309
Mount Martha 3934
FAX NUMBER: 59884175

OFFICE USE ONLY : Date received ............................................... Receipt Number: ................................