|
THE RAILCAR
ORDER FORM
Printable Order Form,
Effective 1 Jan 2005
| 17 The Breakwater |
Corlette,
NSW, 2315, Australia |
| Phone: (61) 2
4981-0668 |
Fax: (61) 2
4981-0668 |
| Email: railcar@nelsonbay.com |
We accept Cheques,
Credit Cards, Money Orders & Cash |
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QTY
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PART NO
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DESCRIPTION |
PRICE |
TOTAL
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Sub
Total |
................. |
| Credit Card Details: |
|
Freight |
................. |
| Type of Card
................................. Expiry Date...................... |
|
Total
Amount |
................. |
| Number
................................................................................ |
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| Name
................................................................................... |
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| Signature
.............................................................................. |
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Aust Freight Costs: Up to $50 - $7.00,Up
to $100 - $9.00,
Up to $250 -$12.00 |
Over $250 - No Charge |
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| Ship To
........................................................................................ |
Phone ................................ |
| Address
....................................................................................... |
Fax .................................... |
| City
......................................... State ................. Code
................ |
Date................................... |
|
E-Mail ................................ |
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