Byron Naturally 2012 Byron Bay & Surrounding Towns Campaign Premier Member – NEW BUSINESS Features include: • Exposure on Byron Naturally category pages and stand-alone page • Professional Video • Exposure on VisitNSW website (400,000+ visitors/month) • Exposure on Byron Naturally Mobile App • Photo Gallery (10 images) • Byron Rewards program • Exposure on BN Social Media sites Complete and return this form by email or mail immediately with full payment or agreement for instalments by credit card. A confirmation tax invoice will be issued and you will be contacted for further campaign details. Business Name: ……………………………………………………………………………………………………………………………………………. Contact Person: .................................................................................................................................................. Business Address: .............................................................................................................................................. Email:................................................................................................................................................................. Bus Phone:……………………………………………………………………Mobile: ...................................................................... Payment by transfer or cheque must be made in full - $2,310 ($2,100 + $210 GST) Credit Card Instalments – amount in full or using following instalment plan: Total Amount of $2,310 Or First Instalment Second Instalment Third Instalment Fourth Instalment ($2,100 + $210GST) Yes / No (due (due (due (due $1,100 $410 $400 $400 by by by by 30th MAY 2011) 30th JUNE 2012) 31st JULY 2012) 31st AUGUST 2012) Total $2,310 ($2,100 + $210 GST) Credit Card Name on Card ......................................................................... Visa / MCard Credit Card No ........................................................................ Expiry Date / Signature ................................................................................ I agree to payment of the four instalments from above Credit Card. Signature……………………………………………………………………….. Date: ……………………………………….. Return this form and payment to: Francis, Secretary for Byron United (mob: 0401 592 114) email: admin@byronunited.org.au Byron United Inc. PO Box 504, Byron Bay 2481 For Campaign information contact: Adrian Nelson, Utopia Creative – 02 6685 6678