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Entertainment Book Order Form

The new 2010/2011 Entertainment™ Books are coming soon!

Cost: $65
Available until: mid May 2010
Group Name: Diabetes WA
Contact: Kirilee Lennerts
Phone Number: (08) 9436 6239
Email: kirilee.lennerts@diabeteswa.com.au

Customers who order and pay for their Book before April 30th 2010 will receive 6 Bonus offers for NEW businesses in the Book. But hurry as stocks are limited and bonus offers will be distributed on a first come, first served basis.

To order your copy of the new 2010/2011 PerthEntertainment™ Book, fill in the form below.

Please note that postage is $8 or $11 for registered post but you can pick your book up from Diabetes WA for free. If you would like to pick it up, simply indicate on the form below.

Contact Details

Name:*

Phone:*

Email:

Address:*

State:*

Post Code:*

Order Details

How many copies?:*

Total cost is (books $65 each):*

Please check this box if you would like to pick your book up from Diabetes WA

I would like to pay $8 per book for postage and handling (Diabetes WA and Entertainment Publications accept no responsibility for books lost through regular mail)

I would like to pay $11 per book for registered mail

I would like to pay by

	Cash
	Visa
	MasterCard
	Cheque - please make payable to: Entertainment Publications

Credit card number:

Expiry date:

Cardholder's Name:

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