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Post to:
| Item | $ Each | Qty | Total |
| Paw-print biro pen | $2.00 |
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| Christmas Card & Envelope | $2.00 |
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| Everyday Card & Envelope | $2.00 |
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| Book Mark | $2.00 |
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| Note Pad | $2.00 |
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| Magnetic Shopping List | $5.00 |
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| Nudge collectable lapel pin | $5.00 |
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| Donation $ (optional) |
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| Contribution to postage $ (optional) |
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| TOTAL $ |
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| Name: | ________________________________________ |
| Postal Address: | ________________________________________ |
________________________________________ |
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________________________________________ |
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| Phone: | ___________________ Fax:__________________ |
| Email: | ________________________________________ |
| Signed: | ________________________________________ |
Please make cheques payable to 'Hearing Dogs for Deaf People NZ'
| I wish to pay by |
Mastercard
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Visa
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| Card Number: | ______________________________________ |
| Name on card: | ______________________________________ |
| Expiry Date: | __________________ |