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To order any of our Zest for Life products by fax, please print out this form, complete in black ink, sign and fax to our offices.
Our fax number is 012.361 0061
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PLEASE NOTE – We charge R 30.00 extra for delivery anywhere in South Africa.
A minimum order of R 150.00 must be placed to qualify for the R 30.00 subsidized courier fee. If your order is less than R 150.00 - a "small order fee" of R 40.00 must be added to your total.
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FAX ORDER FORM | |
Surname | | |
Name |
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Physical address |
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We
courier to physical addresses, but if you wish to have it sent to a box
address, please enter it above. |
| Postal code |
* we need this for courier as well
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| Country |
South
Africa |
| Telephone number |
(Country code + area + number)
+27. |
| e-mail address |
(used to confirm dispatch) |
| Items required |
Item name |
Quantity |
Price
(ZA
Rand) |
Total |
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Delivery
charge |
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TOTAL TO BE BILLED |
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| Credit card details |
| Credit card type |
(Specify Visa, MasterCard, Amex or Diners) |
| Card number |
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| Expiry date |
Month then year |
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| CCV number |
Visa and MasterCard cards > |
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Amex cards > |
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| Your signature |
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| Special instructions and notes |
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