Powertool City Order Form

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• Please provide the following contact information: (Fields marked with an asterisk must be filled in)

• Title
  First name	*
  Last name	*
  Home address	*
  Address (cont.)
  City
  State/Province
  Zip/Postal code
  Country
  Work Phone	*
  Home Phone	*
  FAX
  E-mail	*

• Please provide the following ordering information: (Don't Forget to allow for Freight if your order is under $600.00)

• QTY	DESCRIPTION	PRICE

  	FREIGHT
  Freight Costs	Auckland Central North Island Remote North Island Lower North Island South Island Low Value Freight NZ Post "Economy" NZ Post "Air" NZ Post "Express" Consolidated Freight Over $600 Order - Freight Free

  	BILLING
  Payment Method	VISA MasterCard American Express Diner's Club Farmacard Cheque Enclosed Cash Enclosed
  Cardholder name	*
  Card number	*
  Expiration date	*

  	SHIPPING (Orders usually take about 5 working days)
  Street address	*
  Address (cont.)
  City	*
  State/Province
  Zip/Postal code
  Country

To order online please press submit

If Paying by Cheque, please do not press submit, but print this form and Mail it with your payment.

If paying by Cash, please do not press Submit, but print this form and send by Courier or Registered Mail

If you are concerned about security and wish to order Offline, Please follow this procedure:

1. Disconnect from the internet with this window still active

2. Fill in the Form

3. Press ctrl + P, and select your fax driver

4. Send to any of the New Zealand numbers listed below

Powertool City

439 Grey Street, Hamilton East, New Zealand

Ph / Fax ) (0064) (07) 957 3831 or 957 3830 or , 823 4181

Copyright Powertool City.
Last revised:December 02, 2004