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Attach one page to each lifejacket prior to shipment.
Order No.____________
Name___________________________________
Address_________________________________
__________________________________
Email____________________________________
Phone No.________________________________
Mobile No._______________________________
PFD/Style/Size/Colour_______________________
________________________
Service only Yes/No Circle one
Service & clean Yes/No Circle one
Additional repairs____________________________
Call when ready Yes/No Circle one
Hold to collect Yes/No Circle one
Dispatch Yes/No Circle one
Date required by_________________
Certified & Accredited with:
Stormy Seas, Burke Marine, Marlin Australia,
Jarvis Walker, PFD Australia,
AXIS PFD's & SOS Marine.
Accepted forms of payment are, Cash Electronic Funds Transfer, MasterCard or Visa.
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