publications order form

To order any of ACMI's publications please fill in this form, including your signature, and return it with your credit card details or payment by cheque (payable to 'Australian Centre for the Moving Image') to:

ACMI Publications
PO Box 14
Flinders Lane
Victoria 8009
Fax (03) 8663 2211

ABN 37 375 237 227

You can fill in this form online - type directly into each box, then print it out - or you can print it out and fill it in by hand.

Any questions? Contact the ACMI Box Office on (61) (3) 8663 2583 or email info@acmi.net.au

ACMI respects your privacy.

your details
title
first name
surname
delivery address

suburb
state
postcode
daytime telephone
mobile
facsimile
email address	(correspondence will be via email if you provide email address)

Publication title	Quantity	Price (inc GST)
		$
		$
		$
		$
		$
Postage Please add appropriate postage. See individual title for postage costs. Contact us for discount rates for multiple items.		$
Total		$

payment details

	I wish to pay by cheque and enclose a cheque for the amount of	$
	or
	Please debit my credit card for the amount of	$

credit card details
name of cardholder
card type	Visa Mastercard Bankcard
card number
expiry
date

signature	_________________________________

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publications order form

your details