| FAX ORDER TO - 9822 4951 |
| DELIVERY DATE | ________________________________PREF. TIME AM/PM (please circle) |
| NAME | ________________________________________________ |
| DELIVERY ADDRESS | ________________________________________________ |
| | ________________________________________________ |
| CONTACT NUMBER | ________________________________________________ |
| PAYMENT METHOD |
| CREDIT CARD | VISA | MASTERCARD | |
| CREDIT CARD NUMBER | ________ | ________ | ________ | ________ | EXP: ___/___ |
|
| CASH/CHEQUE ON DELIVERY |
| PLEASE NOTE: A DELIVERY FEE WILL APPLY TO ALL ORDERS |
PLEASE LIST YOUR ORDER BELOW - PLEASE INCLUDE QUANTITIES OR MEASUREMENTS AS APPLICABLE eg: 1 CUBIC METRE TOPSOIL
|
QTY | MEASURE | PRODUCT | PRICE | | Eg1 | METRE | TOPSOIL | $38.00 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | DEL. FEE $ | ______ | | | | TOTAL $ | ______ |
|
