Music At Mod Purchase Form | Perth Modernian Society

Thank you for your interest in our new book, Music at Mod.

Please complete the below form to purchase your copy, or alternatively download a printer-friendly version here.

Order Details

Item:

Purchases can be collected from the school reception:
90 Roberts Road, Subiaco WA 6008
Monday–Friday, 8.00 am–3.45pm.

Purchases can also be collected at the launch event:
Friday 1 December 2023 at 6pm
Beasley Hall
Perth Modern School
Please RSVP if you haven’t already done so.

Number of books:

Price:

I wish to donate:

$.00

Total amount due:

Contact Details

Name:

Email address: *

Phone number:

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Payment Details

Payment method:

Please pay to:

Perth Modernian Society Museum Association Inc.
BSB: 302 162
Account: 126455 6
Description: Your surname and initials

Please make payable to “Perth Modernian Society Museum Association Inc” to complete the transaction.

Payment reminder:

Please send me a reminder email with these payment details

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We will only use the credit card details above to complete this transaction for the Music at Mod book. Credit card details are not stored by this website.

Cardholder’s signature:

I give permission for Perth Modernian Society Museum Association Inc. to use my card details to complete this transaction