Payment Form
Your Details: (
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You can also print out this form and post it to:
Mana Retreat, RD 1, Coromandel 3583, New Zealand
or FAX to 0064 7 866 8214 or send via email: be@manaretreat.com
Note: all fields with an asterix
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are required.
First Name
*
Surname
*
Email
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Telephone
Message
Please select your Payment Method
Direct Credit BNZ Coromandel 02-0304-0312089-00
Cheque payable to: Mana Trust
Credit Card Payment
Payment Amount
*
NZ$
-
If you are making your payment via Credit Card, you will be redirected to our Secure Online Payments page