Club Order Form

Club Order Form
2016 WIA Callbook
The Annual Amateur Radio Callbook Published By The WIA
Special WIA Affiliated Club Offer
As a special offer to all WIA affiliated clubs the WIA is
pleased to offer free delivery for a box of 16 callbooks
delivered direct to your club anywhere within Australia.
So to receive free delivery of callbooks for your club
complete this form and mail or fax the form with payment
to the WIA office.
Bulk Order You Club Callbooks Today
Affiliated Club Name ______________________________________________________
Delivery Address _________________________________________________________
Suburb _______________________________State________________ Pcode ________
Email Address ___________________________________________________________
Contact Name _________________________________
Phone Number ________________________________
Prices Mail to : WIA PO Box 2042
2 - 5 Callbooks $25 each plus $15 delivery.
6 - 10 Callbooks $25 each plus $25 delivery
Bayswater Victoria, 3153
Or Fax : (03) 9729 7325
Full box of 16 callbooks $400 per box with FREE delivery.
Please send me ____ Callbooks (quantity)
Total Inc. Delivery $_____________
Payment Method (please select type)
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c
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Cheque
Money Order
MasterCard
Visa
Card Number
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Expiry Date
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CCV
I authorise Payment of $________c c c
Signature ______________________________________
Name on card _________________________________
Please Note : Payment is required with your order
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