ORDER FORM

"Long Pad Home" by Lloyd Hancock

To order at $33 a copy (GST included) plus $7.00 postage and handling* please print and complete this form and return it to:

Youth Enterprise Trust
PO Box 46
Tamborine Qld 4270

Preferred Title: Mr, Mrs, Ms, Miss, Dr, Prof (please circle)
Name: ____________________________________
Address:

____________________________________

____________________________________

____________________________________

Phone Day: ______________
After Hours: ______________
Please indicate number of copies: ______________

Enclosed is my cheque made payable to the Youth Enterprise Trust, OR

Please debit my credit card.
Bankcard   Mastercard   Visa

Name on Card: ____________________________________
Card Number: ____________________________________
Signature: ____________________________________
Expiry Date: ______________

*For multiple copies of the book email or phone YET (07 5543 6899) for postage and handling costs.

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