BODYSAFE SAFETY SOLUTIONS

 

ORDER FORM

1066 Dunolly Road, Phone/Fax: 03 5469 7202

Dunolly, Victoria, 3472 Mobile: 0419 320 201

www.bodysafe@iinet.net.au www.bodysafe.com.au

 

Print out this form, fill in your details and send with a cheque, money order or your credit card details to the above address:

 

Name: .

 

Street: .

 

Town: .

 

State: .. Postcode: ...

 

PAYMENT METHOD:

Cheque Full name on card: .

Money Order Credit card Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Credit Card Type of card (eg. Visa): . Expiry Date: ./..

 

ORDER DETAILS: Please tick item/s required, below.

 

Tow Bar Protector. Speed Awareness Indicator. Sleep Assistant for Snoring

or Sleep Apnoea.

BarGuard Speed Limiter Snooze-Well

Costs: $15.00ea $25.00ea$25.00ea

 

Quantity: .

 

Postage/
handling: $ 8.50 $3.00 $ 5.00

Any Amount Any Amount Any Amount

 

Total Amount: ..

 

(Phone A/H 03 54697235 for trade and fleet prices)