Southern Gold Coast Masters Australian Football Club Inc.

Business Information

Southern Gold Coast Masters Australian Football Club Inc.
ABN: 15128496672
Australia
admin@sgcm.com.au

Plan details for Greylow - Single ($40)

By completing the form below, you agree that Southern Gold Coast Masters Australian Football Club Inc. will securely store your payment details on file and will charge you automatically when a payment is due.

Amount	Description	Debit Schedule
AUD 40.00	Greylow - Single Ticket $40 If you are wanting only a double ticket for $70 (single $40 plus partner $30), go back and click the other link on the website	Immediately

How would you like to pay?

Credit / Debit Card ( Processing fees apply )

Bank Account ( Processing fees apply )

Payment processing fees will apply

Domestic Card Fees
American Express	2.50% + $0.30
Visa / Mastercard	1.95% + $0.30

International Card Fees
American Express	3.90% + $0.30
Visa / Mastercard	3.90% + $0.30

Credit Card Details

All fields are required unless marked as optional.

Company Name (Optional)

First Name

Last Name

Address Line 1

Address Line 2 (Optional)

City

State

Postcode

Email Address

Card number (no dashes or spaces)

Security Code

Exp. Month

Exp. Year

Name (as it appears on your credit card)

**Please ensure that your invoice payments are kept up to date to avoid financial penalties or further action including debt collection.

Payment processing fees will apply

Domestic Bank Fees
Direct debit	1.00% + $0.30

Bank Account Details

All fields are required unless marked as optional.

Company Name (Optional)

First Name

Last Name

Address Line 1

Address Line 2 (Optional)

City

State

Postcode

Email Address

BSB Number

Account Number

Bank Account Name

**By entering this agreement, you approve Southern Gold Coast Masters Australian Football Club Inc. to debit the nominated bank account above.

By submitting you acknowledge that you have read the Direct Debit Request Service Agreement by clicking here. A copy of the DDRSA and your completed DDR will be emailed to you for your records.