MANTRA MIX CD - ORDER FORM

(1996 Australian release only)

To order the Australian Mantra Mix CD, please print out this page, fill in the details and fax or send it to the address below.

Mantra Mix Order Form

FORMAT	PRICE	POSTAGE	QUANTITY
CD	A$25	.	.

ADD POSTAGE CHARGES:
A$5.00 up to 2 CD’s anywhere in Australia
A$10.00 for 3 CD’s or anywhere in Australia
A$8.00 for 1 CD anywhere in Asia/Pacific/NZ
A$9.00 for 1 CD in UK/Europe/USA
(NOTE: ALL CHARGES ARE IN A$ - AUSTRALIAN DOLLARS)

NAME ________________________________________________________

ADDRESS _____________________________________________________

_________________________________________________________________

PHONE NUMBER (please include area code)__________________________

FAX NUMBER (please include area code)_____________________________

MODE OF PAYMENT:

BANKCARD/ MASTERCARD/ VISA (Please Circle)

BANK CHEQUE/MONEY ORDER in Australian Dollars only (Please Circle)

Note: Please make cheques or money orders payable to "AUSTRALIA TIBET COUNCIL"

CARD NUMBER DETAILS___________________________________________ EXPIRY DATE _____________

NAME ON CARD _____________________________________________

SIGNATURE _________________________________________________

TOTAL AMOUNT_____________________________________________

ADDRESS: "MERCHANDISE OFFICER",

AUSTRALIA TIBET COUNCIL,

PO BOX 1236, POTTS POINT,

NSW, 2011, AUSTRALIA,

FACSIMILE: +612 9283 3846, PH: +612 9283 3466, EMAIL: tibetcouncil@atc.org.au

Every purchase of Mantra Mix helps Tibetan refugees.

THANK YOU FOR YOUR ORDER.