GeyserDuvet | Order Form

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Order your geyserduvet here!

Complete this form and we will send you an invoice as soon as possible.

bill to:
*Full name
Company (if applicable)
*Email Address:
*Contact Number:
*Billing address:
delivery options:
Delivery:	I will collect from The Village Work Centre, Claremont (Cape Town) I will collect from The Forrest Farm, William Nicol Drive, Bryanston, (Gauteng) Please deliver to my nearest post office (delivery fee of R70.00) Please deliver to my door (courier delivery fee R90 for a standard pack) Please select an option.
Delivery address: (If you have chosen postal delivery, please enter your postal address here)
Installation:	DIY (or your plumber/handyman) Please recommend an installer in my area
your order (Choose from this table to calculate your requirements)
Number of packs required:	Standard Packs (R339.00 each) Extra Small Packs (R324.00 each) Small Packs (R328.00 each) Large Packs (R379.00 each) Extra PipeDuvets (R21.14 each) Extra Duvet panels (R92.50 each)
I'm not sure - please call me to discuss before ordering
Comments: Please include any details you have about your geyser (make, model, size) so that we can check your order for suitability .
if you wouldn't mind, we'd like to know:
How you found out about us?	Flyer Website Magazine Ad Friend Web Search Google Ads Other
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