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Subscription Order Form for Registered User Weather Services

Type in your details, then PRINT this form. (Where pagination is important, please specify the preferred font size.) RETURN THIS PAGE COMPLETED TO ORDER YOUR ACCESS SERVICE: Fax or Mail to your nearest Bureau of Meteorology Regional Office
1. Personal Details:
Name:
Company:
Street Address:
Post Code: State:
Telephone:
Fax:
E-mail:
Contact Method: E-mail Fax Post
2. Data requirements:
Product Name:
Length of Subscription:
Acceptance of Conditions of Use:

I accept standard conditions of use

Potential secondary distribution arrangements to be negotiated

Quoted Cost: Please fill in - see Charges for details
3. Payment:
(A) Please charge my BANKCARD MASTERCARD VISA CARD
Card Number:
Card Holder's name:
Expiry Date: /
Date:__________ Signature:______________________________
(B) Enclosed is my cheque for:
Note: Allow a few working days for your order to be processed. We will then send you your access information via your preferred method nominated on the order form (e-mail, fax or post)

For any further enquiries, please send an e-mail to: webreg@bom.gov.au or fax it to 1800 630 101 or
61 3 9602 2808

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