Bulk Order Form - AI Badges - Paid by Credit Card | Amnesty International Hong Kong

locale_link:

http://www.amnesty.org.hk/chi/node/20223

I am /We are happy to support "AI Badge Day". Please find below the details of my/ our order:

Name of Contact Person: *

Name of group / organization (if applicable):

Capacity:

Mail Address (Not applicable for personal collection):

*To control cost, we can ONLY deliver the "Candle Badges" to your address FOR FREE should your order is equal to or over 50 in quantity.

Tel:: *

Email address:: *

Order Quantity (yellow badges) @ HK$20:: *

Order Quantity (blue badges) @ HK$20:: *

Total Quantity: *

Amount (HK$): *

Mailing/Delivery Cost (Not applicable for personal collection):

Total AMOUNT (HK$): *

Below please find the information of my credit card:

Pay with:: *

Credit Card No. (DON'T leave any space between groups of numbers): *

Name on Card: *

Expiry Date (Month): *

(Year):

"*" = compulsory fields

Proof of Purchase:: *

No receipt is issued for any buyer. Should you need any proof of purchase, please check the box above.

The size of badge (pin), excluding the stick: 2.5cm (width) X 2cm (height)

Enquiry hotline: 2152 2061

How did you know this event?: *

Please enter the characters you see in the image into the box below (case-sensitive): *