Welltara presents…

Thanks for your interest!

Please fill in this form and make payment to our bank account

Contact Form ver 2

Number of copies of 'Miss Punk-Chewation to the Rescue' at $20.00/copy. Postage $5.00 for up to 4 books.

First Name

Last Name

Address

Address Line 1

Address Line 2

City/Town

Postcode

Country

Phone no.

Total amount deposited to Kiwibank. Account name: Welltara. Account number:38-9020-0859884-00. Please include your name as a reference.

Your Message

Pamela Stainton, 9 John Witton Drive, Crofton Downs, Wellington 6035