Fax order form

If you prefer to order via a fax order, please print out this page, fill in your order and your credit card detail below, and fax it to our operational offices at fax (South Africa) +2786 542 0381.

To go to our home page please click here.

Name and surname  
Credit card type Visa / MasterCard / Amex / Diners (Circle the type)
Card number _ _ _  _ - _  _  _  _ - _  _  _  _ - _  _  _  _
Expiry date Month (............)
Year (............)
CCV number
 (3 digit number on the back of your card on the signature strip)
E-mail address  
Full postal address line 1
line 2
line 3
State / Province / Zip + Country code
Signature as on card:  


 

Items required

Quantity

Total

$      
$      
$      
$      
$      
$      
$      
$      
$      
$      
SHIPPING VIA COURIER $
X.XX

Remember - A shipping quote will be provided since shipping is not included in the prices.

Total $

To access the South African fax form, please click here.