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Unlikely Agent Order Form

This document is an order form for the book "The Unlikely Secret Agent" which costs R169.95. It requests the customer's contact information and provides payment details, including bank account information for electronic transfer or credit card details. Orders received by Women's Day on August 9th, 2010 will receive a signed copy and free delivery within South Africa, with a R35 delivery charge applied to later orders.

Uploaded by

Angela Godfrey-Goldstein
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
177 views1 page

Unlikely Agent Order Form

This document is an order form for the book "The Unlikely Secret Agent" which costs R169.95. It requests the customer's contact information and provides payment details, including bank account information for electronic transfer or credit card details. Orders received by Women's Day on August 9th, 2010 will receive a signed copy and free delivery within South Africa, with a R35 delivery charge applied to later orders.

Uploaded by

Angela Godfrey-Goldstein
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HOW TO ORDER THE UNLIKELY SECRET AGENT...

ORDER FORM

Retail Price: R169.95


ISBN: 978-1-77009-890-9
For orders call: 011 628 3200 or email: sales@jacana.co.za

personal details
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

payments
Rand Account
Standard Bank of South Africa
Swift Code: SBZAZAJJICM
Branch: Johannesburg
Branch Code: 000205
Bank Account: Jacana Media (Pty) Ltd
Account Number: 000421162

OR

Please debit my visa/mastercard account:

Cardholder name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Expiry date Y Y M M CVC number

All orders received by Women’s Day, 9 August 2010, will receive a signed copy
and free delivery within South Africa.

All orders received thereafter will have a delivery charge of R35 applied in South
Africa only. Please contact us for international orders.

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