Fax/Mail Order Form
To place an order, print this out, complete all sections and fax or mail to Whiteline.
To enquire about price, complete contact details section and list specific part numbers or items your interested in. Fax or mail to Whiteline
| To: | Whiteline Automotive | Ph: | 1800 040 003 | |
| 4 Lincoln St, Minto. | 61-2-96030111 for international | |||
| NSW 2566 Australia | Fax: | 1800 634 834 | ||
| 61-2-98202500 for international |
| Your name: | |
| Ship to: | |
| Post code: | State: |
| Phone: | Fax/E-mail: |
| Part No: | Description |
Qty |
Unit Cost A$ |
Total A$ |
| Total A$ |
| Money order enclosed for A$ | |
| Please charge my credit card (circle) Visa / Mastercard / Bankcard | |
| Name on card: | Expiry |
| Card Number: | Signed: |