Page 314 - Footmedics Catalogue 2019

PRIORITY EXPRESS ORDER FORM
call Footmedics today on 1800 366 863 email us [email protected] visit us at www.footmedics.com.au
INVOICE TO:
Company Name: Contact Name: Phone No.: Invoice Address:
Order No.: Date: / /
ABN No.:
Deliver To:
Suburb:
State:
Attn:
Special Details: Delivery Date Required:
Postcode: Ph:
/ /
AM/PM
ORDER DETAILS: Please photocopy this order form for future use.
Code
Description
Quantity
Unit Price
Total Price
By placing an order we will assume you agree to the Footmedics Terms and Conditions. Prices subject to change without notice. Prices supersede any previously advertised prices. Axis Trust (86 791 535 446) trading as Footmedics, we supply goods and services to you, solely in accordance with our terms and conditions. Our terms and conditions can be found at www.footmedics.com.au/termsandconditions.
As we do not provide advice. It is your responsibility to satisfy yourself that any product or service you receive from us meets your particular needs and requirements.
Name: Position: Signature: Date:
Handling/Delivery $ Subtotal $ GST Amount $ Total Due $
PAYMENT DETAILS:
Please change my credit card.
Please invoice my account.
I wish to apply for
an account.
(First order must be over $150 + GST)
Visa Mastercard Amex
Card Holder’s Full Name:
Card No.:
Expiry Date: Card Holder’s Signature:
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314
BEST PRICE GUARANTEE Email any lower priced quote to: [email protected]