Clubfreedom :: Register Now

REGISTRATION

Click here to complete online registration form in real-time.

OR submit your details using the form below and we will get back to you.

REFERRING SPONSORS DETAILS

Name:

Telephone:

PERSONAL DETAILS

Christian Name/s:

Surname:

Date of Birth:

(DD/MM/YYYY)

Username:

(example: smithj1)

Password:

(minimum 4 characters)

CONTACT DETAILS

Postal Address:

Suburb/Town:

State:

Postcode:

Country:

Email:

Telephone:

(please include area code)

Mobile:

Facsimile:

(please include area code)

PAYMENT OPTIONS

I have interest in obtaining Travel Vouchers

Credit/Debit Card* Direct Deposit** Money Order/Bank Cheque
(Visa/Mastercard only)

Please make money orders/bank cheques payable to "Access International" and forward to:
18 Goenoeng Drive, Tanah Merah QLD 4128.

* If credit card is your preferred payment method, upon receipt of your registration form we will
    contact you via phone to obtain your credit/debit card details.

** If you wish to direct deposit payment, upon receipt of your registration form we will contact
    you via email with our bank account details.

IMPORTANT INFORMATION

I understand that each Travel Vouchers costs US$150 plus US$50 processing fee - a total of US$200 per Travel Voucher.

I understand that I may purchase as many Travel Vouchers as I wish and that these will cost a total of US$200 each.

For conversion to Australian dollars please visit: http://www.xe.com/ucc/

For more information please contact celia@accessduck.com

*Verification Required:
Please type the characters you see in the picture.