* Contact Person

*Address

* Town/City

Province

Country

* Postcode

* Mobile

Work Telephone

Fax

E-mail Address

* Product Ordered

(All fields with an * are mandatory fields and must be completed.)

Company Name:

Account Details: Accolade Accounting cc, First National Bank,

Branch Code 210314, Account No: 6222 2241 789

Deposit/Transfer directly into banking account per details below:

• A Sales Order will be sent to your email address or fax number upon receipt of the order.
• Orders will be executed immediately upon proof of payment.
• Delivery will take place within 1-2 days from date of receiving payment.
• Goods may only be returned within 2 days from date of receipt in their original state and may not have been registered.