-----------------------------------------------------------------------
                      CREDIT CARD ORDER FORM (Rev 1.15)
-----------------------------------------------------------------------
- Notes:
1) All prices are discounted based on C.B.D. Remember to add Credit Card
banking charge to total cost for card orders: V/B/M Cards:3%, Amex:5%
2) We do NOT accept credit cards for International orders. Instead pay
by Telegraphic Bank Money Transfer or Western Union Money Transfer.
3) Please provide a real PHYSICAL delivery address. Not P.O. Box.
4) This order MUST be PRINTED and FAXED TO 03-96905331 or POSTED back
to us WITH THE CARDHOLDER'S SIGNATURE clearly shown.

DELIVERY DETAILS:

NAME/ORGANISATION/BUSINESS_____________________________________________

CONTACT PERSON IF BUSINESS_____________________________________________

STREET AND NUMBER (NOT P.O. BOX!)______________________________________

SUBURB_________________________________STATE__________ POSTCODE________

CONTACT PHONE NUMBER (WORK)_________________ (HOME)____________________

CONTACT FAX NUMBER (IF AVAILABLE)(WORK/HOME)____________________

EMAIL ADDRESS (IF AVAILABLE):__________________________________________

CREDIT CARD DETAILS:

CARD TYPE: ___VISA ___BANKCARD ___MASTERCARD ___AMEX

CARD NUMBER: ________ ________ ________ ________ 

EXPIRY DATE: (MM/YY) ____/____

CARDHOLDER NAME:______________________________________________________

CARDHOLDER SIGNATURE__________________________

TODAY'S DATE: ____/____/________
               DD / MM /  YYYY
TOTAL AMOUNT OF CREDIT CARD DEBIT: $___________________

I hereby authorise Infosat to irrevocably debit my credit card for the
total amount shown.
I agree to the Infosat terms and conditions of trade as displayed at 
www.infosat.com.au/order
I understand that this order is irrevocable.
I am liable for all charges incurred in relation to this order and that
I will be billed accordingly.
----------------------------------------------------------------------
ORDER DETAILS OF GOODS OR SERVICES:




----------------------------------------------------------------------
For enquires contact:
Infosat
Tel: 03-96998844, Fax: 03-96905331, Email: infosat{at}micronica.com.au
Web: www.infosat.com.au
184 Napier Street, South Melbourne, 3205, Victoria, AUSTRALIA