Brain Injury Rehabilitation Unit: Order Form

Personal Details (*Denotes Mandatory Field)

*Name:**		*State/Province:**
Organisation:		*Country:**
*Postal Address:**		*Email:**
*Post/Zip Code:**		Order No.:
Tax Invoice for Australian Purposes
Enter Quantity desired..then Click on "Calculate Results"

*Item*	*Qty*	*Price*		*Amount*
Sex Education Program		$150.00		$
Sexuality Booklet		$5.00		$
Suicidality after tramatic brain injury: A resource manual		$110.00		$
Getting it all together Resource (Government/Private)		$110.00		$
Getting it all together Resource (Non-government)		$66.00		$
PTA Video		$55.00		$
Leaflets about suicidality (max 50) (Order in sets of 10)		$11.00		$
Purchase Price (ex. Goods & Services Tax):				$
Purchase Price (incl. 10% Goods & Services Tax):				$

The amount below is your total purchase price including shipping charge.				CA TOTAL:
Total (International Orders) (Postage & Handling of International Orders (30% of purchase price)		P&H	$	$
Total (Australian) (Postage & Handling of Australian Orders (10% of purchase price)		P&H	$	$