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{ 0 ( + R # ; . # } } Z # z h T W i ( ( # @ : Hook, Line and Sinker Special Edition DVD Order Form
Please send me
QtyItemPrice Total $Hook, Line and Sinker
Special Edition DVD$20 each Postage and Packaging (up to 3 DVDs in New Zealand please contact us for orders over this amount for a price or to post overseas)$ 5 (up to 3 DVD)Total Personal Details
Title:________ Name:_______________________________________________
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A c c o u n t N a m e : M a c u l a r D e g e n e r a t i o n N Z . B a n k : W e s t p a c , S h o r t l a n d S t r e e t
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Mail to: Macular Degeneration, P O Box 137070, Parnell, Auckland 1151
Phone: 09 307 2103 or 0800 MACULA (0800 622852) Fax: 09 307 2021
Email: HYPERLINK "mailto:info@mdnz.co.nz" info@mdnz.co.nz Website: HYPERLINK "http://www.mdnz.co.nz" www.mdnz.co.nz
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