AccliqueLib^® Order Form

Step 1: YOUR ORDER

Please choose the product that you are ordering:

YOUR ORDER

Please choose the product that you are ordering:

Australia

ACCLIQUE Lib^® on CD ($66 + $11 p&h = $77)

Overseas

ACCLIQUE Lib^® for Overseas buyers on CD ($60 + $20 p&h = $80)

Note that prices are in Australian dollars. If you're ordering from somewhere else, you can use this currency converter to convert the amount into your local currency.

Step 2: CONTACT DETAILS

Name:
Address:
Suburb/Town:
State/County:
Postcode:
Country:
Phone (optional):
Fax (optional):
E-mail Address:	(in case we need to contact you)
How did you find this site?

Step 3: PAYMENT

Option 1: Cheque or Money Order

Please print this page and post it to us, along with a cheque or money order in Australian dollars, to:

Jayatarras Pty Ltd

PO Box 2117

Chermside Centre QLD 4032

Australia

Option 2: Credit Card

Fill in your credit card details below, then print this page and post it to the address above or fax it to +61 7 3862 7252 (or 07 3862 7252 within Australia):

Name on card:
Card type:	Select one Bankcard Mastercard Visa
Card number:
Expiry date MM/YY (e.g. 12/01):

Option 3: Direct Deposit

You can pay the amount directly into our bank account:

Bank        : NATIONAL AUSTRALIA BANK
Account Name: JAYATARRAS PTY LTD
BSB         : 084-004
A/C No      : 486 962 735

After you make this payment, please click the "Send Order" button below so that we know about your order.

ACCLIQUELib^® is subject to a full money back guarantee. ACCLIQUELib^® can be run five(5) times prior to registering the product with Jayatarras Pty Ltd. If during this trial period you deem ACCLIQUELib^® to be unsuitable for your needs, please contact us for a full money back refund.