Please fill out the form below with your details and the details of your order and payment. Once complete, please click the "Print Order" link and print it out, and then post or fax it to us for fulfillment. Note that your order will only be transmitted to your printer, and not to our servers; therefore no encryption is required.
We can accept cheques as a method of payment for postal orders. In this instance, please leave the credit card details blank and enclose a cheque (crossed with "A/C PAYEE ONLY") with your order.
PLEASE NOTE: for your convenience, subtotals and totals are automatically calculated as you fill out the form. While all efforts are made to ensure accuracy, A1 Liquid Metal are not responsible for errors and encourage you to verify all calculations and totals prior to sending us your order.
| Customer Details | |
| Name | |
| Postal Address | |
| Delivery Address | |
| Town/City | |
| Postal Code | |
| Telephone (Business) | |
| Telephone (After hours) | |
| Fax | |
| Payment Details | |
| Card Type | |
| Card Number | |
| Name on Card | |
| Expiry Date (MM/YY) | |
| Products | |||
| Product | Quantity | Unit Price | Subtotal |
| Lab-metal (250mL) | $35.90 | ||
| Lab-metal (500mL) | $59.35 | ||
| Hi-Temp Lab-metal (250mL) | $83.65 | ||
| Hi-Temp Lab-metal (500mL) | $154.50 | ||
| Lab-solvent (500mL) | $15.40 | ||
| Lab-solvent (1 litre) | $22.65 | ||
| Heat Block (500mL) | $30.20 | ||
| Freight | 0 | ||
| Rural delivery? (add $3.65) | 0 | ||
| Subtotal | 0 | ||
| Plus GST @ 12.50% | 0 | ||
| Order Total | 0 | ||
Please mail this completed form to: A1 Liquid Metal 2/5 Joval Place Wiri AucklandOr fax to: 09 262 0280
Thanks! We look forward to fulfilling your order.