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FEE ACCEPTANCE FOR

ORDER FORM - 1 or 2 Year Redirection Service Orders must be PAID WITHIN 7 days or service will be terminated.
E-Mail Address:
First Name:
Surname:
Address:
Suburb/City:
Postcode/Zip:
Country:
Redirection Fees 1 Year redirection AU$15 (value in Australian Dollars) Redirection Fees 2 Year redirection AU$30 (value in Australian Dollars)
YES, please accept my application for your redirection service. Following is my application and payment details:
User Name (the web address you wish to use:
IMPORTANT: Credit card orders can also be faxed through on (02) 4577 6942 International fax number 0011 61 2 45 776942 Send to: AAA Media Network, PO Box 5518, Dept RDS, South Windsor, NSW 2756 Australia. Only cheques which can be drawn in Australia will be accepted. International Bank Drafts are acceptable from overseas subscribers.
How would you like to pay? Choose any one of the following:
Credit card: Mastercard Visa Bank Card (Australia only)
Cheque: Cheque (please mail this form in with your Cheque).
Service Required: 1 year redirection AU$15 2 years redirection AU$30
AMOUNT $:
Credit Card #
Exp. Date:

Have you visited the local guide yet - every locality in Australia is covered. NSW - VIC - SA - TAS - WA - QLD - ACT - NT