Print to fax or post DIY lead sampling test kits

PRINT ORDER FORM for DIY-SAMPLING LEAD TEST KITS - pdf version of this file
If you wish to make a DONATION to LEAF (Lead Education and Abatement Fund)
Please use the form at www.lead.org.au/sb.htm

Prices quoted are for Australia only and include sampling instructions and equipment, GST, postage to you, handling, lab analysis and interpretation. Please use our contact form [www.lead.org.au/contact.htm] to request our bank account details so you can send your EFT payment receipt to accompany this print order form, or if you are from another country & want to ask about buying a kit.

No. of kits required ______ Comprehensive (8 sample) Kit $275 or $250 for LEAD Group members
No. of kits required ______ Basic (2 sample) Kit $120 or $100 for LEAD Group members
No. of kits required ______ Water (2 sample) Kit $100 or $85 for LEAD Group members

Join The LEAD Group today! Membership is only $5 per annum

Please find enclosed my payment (cheque / money order / EFT transfer receipt, etc)
for $________payable to: “The LEAD Group" being for DIY-sampling test kit/s.

For payment by mail, print this form and send with a cheque, money order (international money order if outside Australia) or your printed EFT payment receipt to:
The LEAD Group Inc.,
PO Box 161
Summer Hill NSW 2130 Australia
OR fax this form to:
02 9716 9005
OR phone us with all these details, on:
02 9716 0014
OR Freecall
1800 626 086 (Australia only)

OR, please charge the total amount of $____________ to my:

Visa Card £ Master Card £ (tick one)

Cardholder’s Signature:

__________________________________________________

Name on Card:______________________________________

CARD NO. ££££££££££££££££

Expiry date: _____ / _____ 3-digit Security Code: £££

Name &/or Organisation and Postal Address:

_________________________________________________________

________________________State: ____________ Postcode:_______

Email: ____________________________________________________

Ph / Mobile: ________________________________________________ - pdf version of this file

The LEAD Group [ABN 25 819 463 114] Inc is endorsed as an Income Tax Exempt Charitable entity under subdivision 50-B of the Income Tax Assessment Act 1997. The Lead Education and Abatement Fund (L.E.A.F) is a public fund listed on the Register of Environmental Organisations under Item 6.1.1 of subsection 30-55(1) of the Income Tax Assessment Act 1997 and is endorsed as a Deductible Gift Recipient under subdivision 30-BA of the Income Tax Assessment Act 1997.

Visitor Number