Fax and Mail Order Form

(Please refer to our payments page for freight charge details.)

Please print this Order Form (Ctrl+P) post*, or fax your order to (03) 544 6603

Name:...........................................................................

Delivery Address:.....................................................................

.........................................................................

Town/City: .............................................................................

Phone No:................................

Fax No:...................................

Email:..................................................................

Product Description	Number required	Price




Freight		See Above
All Prices listed on web site Include GST $NZ Total

Payment by Cheque *Allow time to clear Credit Card (Details Below)

Type Of Card: Visa MasterCard Issuer (Bank ? etc) .....................

Name On Card: ................................................... Expiry Date: ....... /........

Card Number: ............... ............... ............... ...............

Signed:..................................................................

*Post Cheque to: FAV Mobile Solutions P.O. Box 3239 Richmond Nelson 7050