Order Form
Click here to print
Please note: All prices in $NZ dollars
| Product | Price (incl GST) | Quantity | SubTotal |
| Alpha PowerPill Fe-3+ single pack Petrol | NZ$41.50 | ______ | ____________ |
| Alpha PowerPill Fe-3+ single pack Diesel | NZ$41.50 | ______ | ____________ |
| Alpha PowerPill Fe-3 two pack Petrol | NZ$82.00 | ______ | ____________ |
| Alpha PowerPill Fe-3 two pack Diesel | NZ$82.00 | ______ | ____________ |
| Alpha PowerPill Fe-3 five pack Petrol | NZ$200.00 | ______ | ____________ |
| Alpha PowerPill Fe-3 five pack Diesel | NZ$200.00 | ______ | ____________ |
| Freight: |
NZ$8.00 |
||
| TOTAL: |
____________ |
Delivery Details
Name: |
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| Street: | ||
| Town/City: | ||
| State/Province: | ||
| Country: | ||
| Phone: | ||
| FAX: | ||
| e-Mail: | ||
| Other: | ||
Please print this form and post, along with your
cheque to:
AlphaSouth
C/- Bruce & Jenny Harrington
26 Gordon Terrace
Gore
Southland
New Zealand
Phone Intl: +64 3 208 9736
National: (03) 208 9736
Thank You!
Your order will be shipped as soon as the funds are cleared through our bank.