Publications/Database Purchase Order
1.---Print publication list for reference.
2.---Print this page.
3.---Complete the order & payment summary.
4.---Fax the form to SIRA on +61-2-6296 1937 (Credit card and TT orders only) OR
-----Post with check payable to SIRA at: GPO Box 2609 Canberra 2601, Australia.
Company:__________________________ Contact:_______________________* Payable to SIRA International Corporation in A$ equivalent of US$ (net of bank fees) toAddress:__________________________ Title:_______________________
__________________________ Phone:_______________________
City:__________________________ Fax:_______________________
Zip:______ Nation:____________ Email:________________________
Report:_______________________________________ Price US$:_____________
Report:_______________________________________ Price US$:_____________
Report:_______________________________________ Price US$:_____________
Postage/item @ $10 Aust $15 Asia $20 USA/Europe US$:____________________
Paid By:( ) Check ( ) TT* ( ) Credit Card
Card Number:__________________________ Total US$:__________________
Card Type:Amex/Diners/Mastercard/Visa Expiry Date:________________
Signature:____________________________ Name:_______________________
SIRA International Corporation
Postal Address:____GPO Box 2609, Canberra ACT 2601, Australia
Tel: +61-2-6296 1933 - Fax: +61-2-6296 1937 - Email: sira@siracorp.com
Webpage: http://www.siracorp.com/sira