Africa Asia Australia / NZ China India Indonesia

PROMAX ASIA PTE LTD 3C Tank Road Singapore 238060 Main +65 6736 1435 www.promaxasia.tv

GST No. 200304882N ABN No. 72800597490

DUPLICATE AWARDS ORDER

Please fill out this form completely.

Your Order

Member / Non-member Quantity Amount Trophy S$250 / S$400 Certificate S$100 / S$142

Place:

Gold Silver

Event Presented:

Year ______

Africa Asia Australia / NZ China India Indonesia

______Awarded to (Organization Only)

______Title of Entry

______Category Title

______Personal Recognition

PROMAX Awards or Certificates can only be ordered by those individuals or organizations included in the credits of the winning entries. Please indicate personal credit on the "Personal Recognition" line provided above.

Page 1 of 3 SHIPPING ADDRESS

______Name Member #

______Title/Position

______Company

______Address 1 (No P.O. boxes. Street address only)

______Address 2

______City State/Province

______Zip/Postal Code Country

______Telephone E-mail

SHIPPING & HANDLING FEES

Please select one:

You arrange for your courier service to pick up your package(s) at our Singapore office. We provide you with the details – our office address, package weight & size, etc. - No handling fee.

We arrange with DHL for the delivery to you. Shipping fee to be confirmed and included in your invoice after submitting this order form. Custom charges, if any, are borne by you. - S$50 handling fee. - Total Cost = Cost of trophies + Shipping fee + S$50

No charge for certificate(s).

Page 2 of 3 PAYMENT DETAIL

Please select one:

Wire Transfer

Billing Address, if different from shipping address:

______Name