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<strong>Entrepreneur</strong> <strong>Magazine</strong> Print Subscription<br />

INDIVIDUAL / GIFT SUBSCRIPTION<br />

Offer 1:<br />

Subscribe <strong>to</strong> 12-issues of <strong>Entrepreneur</strong> <strong>Magazine</strong> now for only R344.64 incl. VAT<br />

Offer 2:<br />

Subscribe <strong>to</strong> 24-issues of <strong>Entrepreneur</strong> <strong>Magazine</strong> now for only R26.93 per month<br />

for 24 months.<br />

Offer 3:<br />

Subscribe <strong>to</strong> 36-issues of <strong>Entrepreneur</strong> <strong>Magazine</strong> now for only R25.13 per month<br />

for 36 months.<br />

Offer restricted <strong>to</strong> RSA.<br />

Personal Details<br />

First Name<br />

Surname<br />

Postal Address<br />

Postal Code<br />

Email Address<br />

Tel No. (W)<br />

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Gift Subscription Recipient Details<br />

Complete this section only if you are purchasing this <strong>subscription</strong> as a gift for someone else:<br />

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Birthday<br />

Cell No.<br />

Send <strong>the</strong> free gift (below) <strong>to</strong> me<br />

or <strong>to</strong> <strong>the</strong> gift recipient<br />

INDIVIDUAL / GIFT SUBSCRIPTION • Contact Dean Harty on +27 (0)11 886 6880 for assistance.


Free Subscription Gift<br />

If you have selected option 1, please select one of <strong>the</strong> following:<br />

___ Business Start-up CD Power Pack<br />

___ Business Growth CD Power Pack<br />

O<strong>the</strong>r (if applicable): _____________________________<br />

*Valid while s<strong>to</strong>cks last • Gift/s sent separately by registered mail<br />

Payment Instruction<br />

Authorisation for Payment<br />

NB: THIS BOX MUST BE COMPLETED & SIGNED<br />

I, <strong>the</strong> undersigned, hereby authorise <strong>the</strong> magazine <strong>subscription</strong> requisition. I confirm that I am authorised<br />

on behalf of my organisation <strong>to</strong> authorise this payment.<br />

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Date:<br />

INDIVIDUAL / GIFT SUBSCRIPTION • Contact Dean Harty on +27 (0)11 886 6880 for assistance.


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Option2:<br />

I hereby authorise <strong>Entrepreneur</strong> Media SA (Pty) Ltd <strong>to</strong> debit <strong>the</strong> above amount of R26.93 per month for 24 months<br />

from <strong>the</strong> following account:<br />

Option3:<br />

I hereby authorise <strong>Entrepreneur</strong> Media SA (Pty) Ltd <strong>to</strong> debit <strong>the</strong> above amount of R25.13 per month for 36 months<br />

from <strong>the</strong> following account:<br />

Please select a day: 1 st<br />

25 th<br />

Bank<br />

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Branch<br />

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If, however any transfer of funds is unsuccessful, I/ we understand that a penalty of R20.00 (incl. Vat) will be levied when<br />

<strong>the</strong> next debit order run is due. All such withdrawals from my/ our account by you shall be treated as though <strong>the</strong>y have<br />

been signed by me/ us personally. This authority may be cancelled by me/ us by giving you 60 day’s notice in writing only<br />

after <strong>the</strong> first 12 months of <strong>the</strong> <strong>subscription</strong>.<br />

Credit Card Authorisation:<br />

Option1:<br />

I hereby authorise <strong>Entrepreneur</strong> Media SA (Pty) Ltd <strong>to</strong> debit <strong>the</strong> above amount of R344.64 from <strong>the</strong> following account:<br />

Option2:<br />

I hereby authorise <strong>Entrepreneur</strong> Media SA (Pty) Ltd <strong>to</strong> debit <strong>the</strong> above amount of R646.20 from <strong>the</strong> following account:<br />

Option3:<br />

I hereby authorise <strong>Entrepreneur</strong> Media SA (Pty) Ltd <strong>to</strong> debit <strong>the</strong> above amount of R904.68 from <strong>the</strong> following account:<br />

American Express & Diners Club credit cards not accepted<br />

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Credit Card No<br />

Last 3 digits on <strong>the</strong> back of <strong>the</strong> card Expiry Date MM ______ YY ______<br />

Electronic Transfer or Direct Deposit<br />

Please indicate your name & surname as a reference<br />

Account Holder:<br />

Bank:<br />

Account Number: 1286086310<br />

Branch Code: 128605<br />

<strong>Entrepreneur</strong> Media SA (Pty) Ltd<br />

Nedbank, Western Gauteng Business<br />

Fax proof of payment <strong>to</strong> +27 (0)11 789 9113<br />

INDIVIDUAL / GIFT SUBSCRIPTION • Contact Dean Harty on +27 (0)11 886 6880 for assistance.

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