Employers Assistance Order
You can print this and have the following options:
 

Scan and email this completed form to info@employers.co.nz

Mail this completed form with a cheque for the total amount to
 Employers Assistance Ltd
 P O Box 302 160
 North Harbour
 Auckland 0751
or: Fill out the bottom with your credit card details and Fax to 09 447 1527
Problem generating order form - Session timed out
Company:
Contact:
Phone: Fax:
Mailing Address:
 
Email:

Payment Details:
 
I enclose my cheque for incl GST, or
I have paid via direct credit incl GST, into ANZ 01 0242 0074272 00
Please charge my credit card (details as below):
   
Visa MasterCard Amex Diners
Card No:                                
Expiry Date:   Name:   Signature  

All enquiries please phone 0800 15 8000
or
email info@employers.co.nz