ONLINE ORDER FORM
 
INVOICE TO: DELIVER TO:
Company Name Attention:
ABN Delivery Address:  
Street
Phone     

FAX

   
Email Town
Contact Postcode
Your Order No.    
PRODUCT CODE DESCRIPTION QTY UNIT PRICE TOTAL

YES, I would like to open a 30 day account

 Subtotal  

Please debit our existing account

 GST  

Please debit my credit card (All cards accepted)

 TOTAL  

For security please telephone 1300 139 930 to give C/Card details

      
We appreciate your business.
Terms Strictly 30day payable on invoice. All goods remain the property of Celkote Pty Ltd until final payment is received. All invoices are inclusive of GST. Please refer to the Terms and Conditions of trade. Please note: Claims not accepted unless requested within 14 days of invoice date. we will always endeavour to maintain the price listed, however, prices may be subject to change without notice

SPECIAL INSTRUCTIONS:
Delivery required by:
Authorised by: