Main Frame

Application & Order Form

STEP 1 - Please provide the following information:

Title

Name (or Company)

Delivery address

Address (cont.)

State

Postal code

Country

Phone

E-Mail

ACF ID No.

(For current ACF members)

Age

Under 18 18 Or Over

Gender

Male Female

Player Skill Level

Beginner
Intermediate
Advanced (Competitive)

STEP 2 - Please provide the following ordering information:

All products FREE delivery Australia wide
Qty.	Membership Type	Subscription Term	Price
	Regular Member Individual or Family	1 Year	$30.00 + Free Gift
	Concession Member Juniors (<18), Seniors (over 59) and Students	1 Year	$27.00 + Free Gift
	Corporate Membership Clubs or Companies	1 Year	$300.00 + Free Gift
Qty.	Official Merchandise Product		Price*
	Official ACF/ICF Limited Edition Striker		$29.95ea.
	Official ACF Polo Shirt (Medium Size)		$39.95ea.
	Official ACF Polo Shirt (Large Size)		$39.95ea.
	Official ACF Polo Shirt (Extra Large Size)		$39.95ea.
	Promotional Carrom Wall Clock		$39.95ea.
Sub-Total $ *New and Existing ACF Members: Deduct 5% off Official Merchandise purchases

**STEP 3 - Please provide the following payment information:**
Method of Payment
Cardholder Name
Card Number
Expiry date
Note: If paying by cheque or money order, please send with this form to: Australian Carrom Federation P.O. Box 1143, Burleigh Heads, Queensland, AUSTRALIA 4220.