Order and Payment Form

Please send to Optimate AlpaFarm by fax to +61 2 4227 5975 or by mail to PO Box U385, Wollongong University NSW 2500, Australia.

Please supply:

Optimate AlpaFarm Unlock Code Only

Optimate AlpaFarm Unlock Code and CD

Optimate AlpaFarm Breeder Edition Three Page Website

AlpaFarm clients: upper and lowercase letters will appear on your reports and screens *exactly* as written here.
Name(s):	_______________________________________ (Please print)
Stud/Farm/Ranch Name:	_______________________________________ (Please print)
AlpaFarm Edition:	Wether / Breeder / Enterprise (please circle)
	Please add my email address (below) to the AlpaFarm opt-in, no-spam, low-traffic Announcement list

Please send to:	email:	___________________________________ (AlpaFarm Unlock Code only)
	Fax:	___________________________________ (AlpaFarm Unlock Code only)
	Postal Address:	Property Name:______________________
		Address 1:_________________________
		Address 2:_________________________
		Town:_____________________________
		State:_____________________________
		Postcode / Zip Code:_______________
		Country:___________________________
	Telephone:	__________________________________

Payment option (please circle one):

(a)	Cheque/money order for $______________ enclosed Cheques must be in Australian dollars, drawn on an Australian bank. Please make payable to Optimate Group Pty Ltd.
(b)	Or charge my credit card: (“Optimate Group Pty Ltd” will appear on your statement.)
	Visa / MasterCard (please circle) Name on card:_______________________________ Card number:_______________________________ Expiry date:_________________________________ CVV:____________________ Amount:_____________________________________	Signature:________________________________
		Office Use Only:_______________________ h266486M

Only if you want to:
Referred by: ______________________________________________
How did you hear of Optimate AlpaFarm? ______________________________________________