MEDIATION
ON CHILDREN'S ISSUES IN FAMILY LAW

Some Information and Tips for Women

(2nd Edition - November 2008)

Purchase Order Form/Tax Invoice

OrderDetails: (All amounts are GST Inclusive)

Please forward _____copies to me @ $10.00 per copy   $__________

Payment Details:

o I enclose my cheque/ money order in payment.            Total: $ __________
         Or
o Please charge this purchase to my:

         MasterCard               Visa               Bankcard            Total: $ __________

Card Number: ___ ___ ___ ___      ___ ___ ___ ___      ___ ___ ___ ___      ___ ___ ___ ___     

Expiry date: ____/ _____   Cardholder’s name:__________________________________

Cardholder Signature:_______________________________   Date:  _____/_____/_____

  Please Send Publications To:

Name:
___________________________________________________________________

Address:
___________________________________________________________________

___________________________________________________________________

_______________________________________________________P/C _________  

Phone:
(_____) _____________________________________________________________

 Send this order form to:

Women’s Legal Service Inc: (ABN:72685 598 982)  
PO Box 119, Annerley Qld 4103, Australia
Fax: (07) 3392 0658