District plan - central area section

Order form

Complete the following form to place your order for hard copies of the plan.

1. Purchaser details * indicates required fields
Name of company or individual *
Attention *
Email address *	Note - if you have a hotmail or yahoo address, please enter an alternative.
Street address *
Postal address *
Daytime phone *
Daytime fax

Enter the number of copies of the plan and if an annual subscription is required
* indicates required fields

Full copy of proposed plan @$500 per copy *
(Please enter the number of copies as a numeric value).

Annual update subscription @$150 per subscription *

Yes

How would you like the plan sent to you? *

	Courier (There will be a $10 courier fee per plan.)
	Collect

* indicates required fields

How would you like to pay? *

My order number/reference for invoice (if applicable):

Hotmail or yahoo address

When we email people, hotmail sometimes treats the emails like unwanted emails (also known as spam). This means that you may not receive them.

Please supply another email address if you are able to.