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.
| Customer Details | |
| Name | |
| Postal Address | |
| Delivery Address | |
| Town/City | |
| Postal Code | |
| Telephone (Business) | |
| Telephone (After hours) | |
| Fax | |
| Payment Details | |
| Please credit payment into our New Zealand bank account: 12-3083-0433875-00 | |
| Products | |||
| Product | Quantity | Unit Price | Subtotal |
| Lab-metal (250mL) | $35.90 | ||
| Lab-metal (500mL) | $59.35 | ||
| Lab-solvent (500mL) | $15.40 | ||
| Lab-solvent (1 litre) | $22.65 | ||
| 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 Ltd 14 Turnberry Dr, Wattle Downs, Auckland, New Zealand
Or fax to: 09 262 0280
Thanks! We look forward to fulfilling your order.