Fax Transmission - Order Form

Complete this form, type Ctrl P to print it out and fax to (03) 8080 1655

Complete the form and print it out or fill it out manually after printing.
By completing this form you are not sending your details over the internet.
To: Chris Bedford - Trading Secrets Pty Ltd - phone 0414 924 010
Fax Number: (03) 8080 1655 Today's Date:

Hi Chris, This fax is to order the following product(s). Please send me confirmation of my order via email and a receipt. Thanks in advance.
Candlestick Charting Home Study Course ( in ring binder )
plus 12 months of personal support via The Trading Game Forum (value $320.00).		 $695.00 (inc GST) Qty: 
Postage rates: 

(include this in your total)
Country Cost per Order Delivery Times
Australia $35.00 (inc GST) 4 - 10 business days
New Zealand $99.00 1 - 2 weeks
Elsewhere $119.00 2 - 3 weeks

Please complete all fields

Name to appear on receipt 
Mailing Address
Suburb
Country/State
Post/Zip Code
Email

Daytime Phone Number
Credit Card
Total Amount
Cardholder Name
Card Number
Expiration Date xx/xx