Simple Savings - Savings Vault Membership Order Form

Please print this order form and fill in all details. You can pay by cheque or money order, or by filling in your credit card details. Mail or fax the completed form with payment to:

Simple Savings, PO Box 1777, Buderim QLD 4556
Fax: 02 9012 0288

Contact Details

First name: ______________________ Last name:______________________

Email: _______________________________________
An email address is essential, as this will be your login name for the Savings Vault.

Password: _____________
Please choose the password you wish to use to access the site (6 characters minimum)

Street Address: ____________________________________

_______________________________________________

Suburb/City: _____________________ State: ________ Post Code: ________

Country: _____________________

Phone: _________________ Fax: _________________

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Payment Details

The price for a year of access to the Savings Vault is GBP £13 including GST. Please fill in your credit card details below or send a cheque or money order payable to Simple Savings International.

Card Type: (please circle)     Visa / MasterCard / American Express

Cardholder Name: ____________________________________

Card Number: ____________________________________  Expiry Date: ____ /____

Cardholder Signature: ____________________________________

OR

__ I've enclosed a cheque/money order.

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How did you hear about Simple Savings? ____________________________________

By completing this order, you are agreeing to our Terms and Conditions

Thank you for your order. We will contact you by email when your membership has been activated.