Guitar Tutor Online - Subscription Payment Form

Please print this form and post to:
Danny Poole
Guitar Tutor Online
P.O. Box 1711,
Aitkenvale BC. 4814.
Townsville, Queensland
Australia.

Compulsory - You must Complete this Area
Full Name .....................................................................................
e-Mail Address
Please print clearly		 .....................................................................................
Username (A-Z / 0-9) .....................................................................................
Users Password .....................................................................................

ITEM
Please tick one.

Pricing is in
Australian Dollars.

LIFETIME MEMBERSHIP - $30.00
All Completed Section CD ROM
      (existing member) - $15.00
All Completed Section CD ROM
      (non member) - $25.00

(Postage $7.50 International, $3.00 within Australia)
Coupon Number:
 If applicable		 .....................................................................................
Mailing Address:
If purchasing CD ROM		 .....................................................................................
Address, State,
Post or Zip Code, Country.		 .....................................................................................

Optional - Additional Information
What country
do you live in?		 .....................................................................................
How long have
you been playing?		 .....................................................................................
Favorite style/s
of music		 .....................................................................................
.....................................................................................
.....................................................................................
List 3 favorite
bands / artists  		 .....................................................................................
.....................................................................................
.....................................................................................
Any special comments   .....................................................................................
.....................................................................................
.....................................................................................
.....................................................................................
.....................................................................................
What speed internet
connection do you have?
Fast Connection - Broadband, ISDN
Standard Modem - 56kbps

Please Note: Cheques will only be accepted if you are a resident of Australia. Overseas customers please pay by money order. You will be notified by email when your account is set up.