CAIRNS ROTARY
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Corporate Duck Order Form
Order Your Corporate Ducks Online
.
Use this form to order your ducks. Please remember our events are manned by volunteers, so your patience and assistance is appreciated in advance!
Your Full Name (*)
Please type your full name.
Organisation (If Relevant)
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E-mail (*)
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Your Street/PO Box Address (*)
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Town (*)
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Your Telephone Number (*)
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Postcode
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How Many Corporate Ducks @ $110 each
Select
1 duck $110
3 ducks $275
5 ducks $440
10 ducks $825
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Will you be Dressing Your Corporate Duck?
Select
Yes
No
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Payment Method. How will you donate?
How To Details will be sent by Email.
Please choose & select
I will post a cheque
I would like to give my credit card over the phone
I would like to fax my credit card details
I would like to transfer into a bank account
I would like to use PayPal
Other (please advise below)
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Comments
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Verify This Form
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A copy of your payment details and more payment instructions will be forwarded to you by email when you submit this form.
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