Print out the attached form, completing all details and either fax to 03 9258 4273 or mail to:

Racing Information Services Australia Pty Ltd
400 Epsom Rd.
FLEMINGTON VIC 3031
Credit Card Application Form

(Please Print Clearly)

Are you renewing your subscription? If so, Username __________________

Surname
 ______________________________
Given Names
 _________________________________________
Initals
___ Titles  Mr   Mr   Mr
Gender
Male   Female
Preferred Name
 ______________________________    
Postal Address
 ____________________________________________________________________________________
Suburb
 ______________________________
State
 _____________ Post Code ___________________
Country
 ______________________________    
Home Phone
 ______________________________
Work Phone
 _________________________________________
Mobile Phone
 ______________________________
Fax
 _________________________________________
Email
 ____________________________________________________________________________________

Tick the appropriate product

HORSE & RACE ENQUIRY

Annual $253 (incl $23 GST)
Monthly $33 (incl $3 GST)
Weekly $11 (incl $1 GST)

WEBFORM

365 Days $187 (incl $17 GST)
180 Days $99 (incl $9 GST)
90 Days $59.40 (incl $5.4 GST)
30 Days $19.80 (incl $1.8 GST)

DOWNLOAD ACCOUNT

$___________

Payment Details: (please tick one box only) Credit Card  Cheque  Money Order

Credit Card Type:  Mastercard  Visa  Bankcard

Card Number:

Expiry Date: ______________________________
Name on Card: ______________________________________________________
Signature: ________________________________
Payment Amount :


All Cheques and Money Orders made payable to Racing Services Bureau
Please allow 7 days for your application to be processed. 
Your User Name and Password will either be mailed or emailed to you if your application is successful.
For application enquiries please call the RSB on (03) 9258 4711.

Racing Services Bureau Home Page