*** FAX ORDER *** TO: The Interactive Multimedia Group Pty Ltd (Australia) FAX Please call +61 3 9561 5590 for the appropriate number Customer Details - (For credit card processing, we need your personal address & contact details here. If you are using our worldwide gift service, please enter your gift recipient's address separately, in the lower section of this order form). Name: Address: Suburb: State & Postcode/Zip: Country: WARNING: Your address above, must match the billing address of your credit card. Any discrepancy in card ownership details or suspicion of fraudulent card usage, will void your order. In this instance, any details submitted including detected facsimile numbers, eMail and ISP addresses, will be passed on to appropriate legal authorities, for investigation. Work Phone: Home Phone: Fax: Email: Product Order Details - Order both music & software here, CD or Cassette 'field' applies only to music product. Enter special promotional offer codes if applicable - *If you are utilising a special promotional offer, please enter the promotion code here _____________. *If you already have Flight Downunder 2002 & wish to take advantage of the special Dance eJay offer, please enter the barcode number from Flight Downunder 2002 _________________. * For You Personally (to the above address): Item 1: Quantity ____ Product _______________________________ CD or Cassette ____ Item 2: Quantity ____ Product _______________________________ CD or Cassette ____ Item 3: Quantity ____ Product _______________________________ CD or Cassette ____ Item 4: Quantity ____ Product _______________________________ CD or Cassette ____ * For Gift Recipient 1 Gift orders attract a small fee of AU$2+GST(within Australia) =$2.20 to cover your gift wrapping & card. Name: Address: Suburb: State & Postcode/Zip: Country: Personal Message (<20 words): Item 1: Quantity ____ Product _______________________________ CD or Cassette ____ Item 2: Quantity ____ Product _______________________________ CD or Cassette ____ Item 3: Quantity ____ Product _______________________________ CD or Cassette ____ Item 4: Quantity ____ Product _______________________________ CD or Cassette ____ Please add freight charges when totalling your payment: Within Australia & New Zealand: Worldwide (Airmail): Product total <$60 $ 5.39 incl GST. $12.90 $60 to $120 $ 8.69 incl GST. $17.90 more than $120 $11.99 incl GST. $24.90 Payment Details (please tick) - [ ] MASTERCARD [ ] VISA [ ] CHEQUE/MONEY ORDER ENCLOSED (from within Australia only) including freight from above scale. [ ] OVERSEAS BANK DRAFT ENCLOSED payable to The Interactive Multimedia Group Pty Ltd (include freight from above scale, plus an extra AU$6 to cover extra processing costs invloved). The amount must be in AU$. Card Number: - - - Expiry: Month ______ Year ______ Card verification ID: Name on Card: Signature of cardholder: Any other comments or special requirements: