Embassy of Australia
United States of America
Embassy address: 1601 Massachusetts Ave, NW Washington DC 20036 - Telephone: (202) 797 3000 - Fax: (202) 797 3168

PLEASE PRINT THIS PAGE, COMPLETE AND ATTACH TO YOUR APPLICATION



By signing the following credit card authorisation, you agree to be charged by United Parcel Service (UPS) for the return of your documents. To calculate rates and shipping times, you may refer directly to the UPS website.


Type of shipping :


□ UPS Next Day Air Early AM (next day delivery by 8:30AM)
□ UPS Next Day Air (next day delivery by 10 :30AM)
□ UPS Next Day Air Saver (next day delivery by 4PM)
□ UPS Ground (4-5 days delivery)


Credit Card Type :

□ Visa
□ MasterCard
□ American Express
□ Discover


 

Card holder's name: ________________________________________

Applicant's name: __________________________________________

Credit Card Number : _______________________________________


Expiration date : ______________


Verification code: _____________ 


Credit card billing address :

________________________________

________________________________

________________________________

 

Postal address:

________________________________

________________________________

________________________________




Cardholder's Signature : _____________________________________ 


 

 

Disclaimer | Privacy | An Australian Government website | Copyright Commonwealth of Australia