Payment

Dina offers several payment options, simply ask about your preference from the list below:

1. CREDIT CARD - you can PRINT the below credit card payment sheet to fax or post to Dina.

2. DIRECT DEPOSIT - or you can arrange a direct deposit via your bank, BSB and account details are available on request.

3. ONLINE PAYPAL - details are available on request..

4. CASH or CHEQUE is also available (terms and conditions apply).

PRINT CREDIT CARD PAYMENT

Name on card: __________________________________________________________

Type of card: ...... mastercard / visa

Card number: ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___

Expiry date:... ___ ___ / ___ ___ ......CVV code (last 3 digits on back):. __________

Amount Paid: ..._$______________ ...... Currency: ..AU / US

Project description: ______________________________________________________

_______________________________________________________________________

Signature: .._________________________________ .... Date: ____________________