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FAXBACK ORDER FORM Corporate Gold Coast Transfers Name: ___________________________________________________ Company: ___________________________________________________ Position: ___________________________________________________ Postal Address: ___________________________________________________ Phone: _____________________ Fax: ________________________ Email: ___________________________________________________ Trips in Book Your Rate Total 10 Airport to Gold Coast / Gold Coast to Airport $230.00 $ 20 Airport to Gold Coast / Gold Coast to Airport $460.00 $ 50 Airport to Gold Coast / Gold Coast to Airport $1,150.00 $ 100 Airport to Gold Coast / Gold Coast to Airport $2,300.00 $ 150 Airport to Gold Coast / Gold Coast to Airport $3,450.00 $ 200 Airport to Gold Coast / Gold Coast to Airport $4,600.00 $ 300 Airport to Gold Coast / Gold Coast to Airport $6,900.00 $ Other (Specify) $ TOTAL $ Gold Coast tickets are valid for travel in either direction between Brisbane Airport and stations on the Gold Coast line. PAYMENT METHOD Credit Card: Card Type: Mastercard Visa Amex Card Number: __________________________________ Expiry Date: __________________________________ Name on Card: __________________________________ Signature: __________________________________ Email: Email ticket order, credit card details and address to info@airtrain.com.au Cheque: Mail order form and cheque to: Airtrain Citylink Ltd, PO Box 66, Pinkenba, Brisbane QLD 4008. Invoice: Airtrain will send tickets and invoice to the address listed above. Please call 07 3216 3308 for enquiries on Airtrain Transfer tickets. FAXBACK: 07 3216 3361 Valid: 1 st July 2008 Office Use Only PO Number: Invoice Number: Date Sent:
