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DONATION AND MAIL ORDER FORM FOR “100 Years of Arc Memories” ARCADIA BOOK
Please complete this form and fax it to Arcadia 00 11 27 11 640-2919
or email these details direct to Arcadia to selwync@jhbchev.co.za
Please send book to: Name:…………………………………………………………………..
Address:………………………………………………………………………………
…………….
………………………………
………………………………………………………………………
City ……………………….. .Code
……………….. Country………………………………
Payment by Credit Card;
Tick card type: Amex … Diners …….. Master Card ………
Visa ………
Credit Card Number … .. . . . … - … .. . . . … -… .. . . . … - … .. . . . … …
Expiry Date . . … - … .. . 3 extra digits at the back of your card . . . . …
Credit Card Holder: ……………………………… Signature…………………………………………….
Amount Rand ………… (Made up of R for book/s and R as a donation)
OR Payment direct into FIRST NATIONAL BANK BRANCH - PARKTOWN
BRANCH CODE 250-455 ACCOUNT NO 54860054731 SWIFT CODE : FIRNZAJJ
but also please remember to email or fax your address and details of payment as above.
MAIL ORDER PRICES USA, UK, Canada, Israel and Australia Rand 300
South Africa Rand 250
NB The books will be available in Australia from 7th June, in the UK 20th June,
and in Israel and the US / Canada and JHB at the end of June.