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Energy Tapping / Emotional Freedom Technique (E. F. T)
Blue Sky Coaching E. F. T. Secure Order Form

This is a secure form. For more information, please read the security statement below.

Please complete this form to place your order. If you wish to print this form, you can type or write by hand your details then print and post it to me, print and fax it to me or submit your order on-line.

Note: All figures quoted are in AU$ (Australian dollars). Current international currecy conversion rates will be applied for all non-Australian orders.

* Required Fields

Personal Details
First Name:*
Last Name:*
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Post Address Line 2:
Suburb/Town:*
Postcode/Area Code:*
State:*
Country:* Australia
  Other:
Phone Number:*
Mobile Number:
Fax Number:
E-mail Address:*
How did you hear about this EFT package?*
Other:
   
Product Order Details
Session / Package:*
(please tick)
EFT Home Study Package
EFT Home Study Package PLUS
Quantity:*
Promotional Code :
Payment Options (please tick)
Subtotal:   AU$
Postage & Handling:   AU$
Total Investment:   AU$
 
Credit Card:
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Visa Card
 MasterCard
Barter Card
Credit Card Number ---
Card Holder Name:
Card Expiry Date:
 
EFT: Please make EFT Payments to:
Tania Basheer T/A Blue Sky Coaching -
Westpac, BSB: 035213, A/C: 159664
 
Money Order:
(Australia Only)		 Please send Money Orders to:
Blue Sky Coaching, P.O.Box 81, Highgate SA Australia 5063
 
I want to pay by
Secure On-line Order: Please click "Register Online" to complete.
Post: Please click "Print Form" and Post registration to:
P.O. Box 81, Highgate SA Australia 5063
Fax: Please click "Print Form" and Fax registration to:
(08) 8338 7934
 
Declaration & Digital Signature
* I agree with the statements made in the Privacy Statement.
* I authorise use of all details provided as stated above.
 
Full Name:*
Date:
Signature:
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the left for verification:
 
 

 
This form can be posted to: P.O.Box 81, Highgate SA Australia 5063
or faxed to: (08) 8338 7934


Security Statement
This form is secure (as indicated by a padlock symbol in the browser and https:// address).

The Blue Sky Coaching website uses a Secure Certificate (RapidSSL), short for Secure Sockets Layer, a protocol for transmitting private information via the Internet. SSL uses a private key to encrypt data that is transferred over the SSL connection. This protocol is a standard used by many websites when you submit confidential information, such as credit card numbers and other personal data. SSL creates a secure connection between your browser and our server.

If you have any concerns or enquiries about your security while using this website, please contact Tania for more information.