Stock requisition form

							                                             RED BOOK 2007 ORDER FORM
                                                        Fax Orders to 02 9744 1830
                                               Mail: PO Box 1106, Burwood North, NSW 2134
                                 For further information contact NECA NSW 02 9744 1099

Customer Order No:
Member Number
Company Name
Delivery Address
Address
Suburb                                                                                           Pcode
Phone                                                                                                  Fax
Contact person
Cost
1-9 books                              $           5.00                   Postage       $      5.00
10-49 books                            $           4.50                   Postage       $     10.00
50-99 books                            $           4.50                   Postage       $     15.00
Per Box (100 books)                    $           4.25                   Postage       $     20.00
Non Members                            $           8.00                   Postage as above depending qty

Payment Options
      Cheque made payable to NECA NSW for $________________attached
      Invoice for the total amount below payable strictly within 30 days (Members only)

      EFT. Please contact the finance department for details
      Please charge my credit card for the amount indicated below
                                      Mastercard                                          Visa
(Note: Diners Club and Amex are no longer available as payment options)

Card holders name

Card Number

Signature                                                                                                     Expiry date
                                                                                                                             M M /Y Y

Stock description                                                                         CODE                QTY           $Amount
Red Book 2007                                                                             HS001
Postage
                                                                                          Total Incl GST                    $

Delivery method                                    Post                   Courier                                Pick up

Courier company                                                                                        A/c
Print name                                                                                             Sign

OFFICE USE ONLY
                                            Date             Initial                                          Date          Initial
Sent to Finance                                                           Rec'd By Finance
Input in Sybiz                                                            Sent to Recp'n
Goods Dispatched
CHECK LIST                                  Tick
Stock item correct                                                        PO total agrees to invoice
Stock quantity correct
Invoice attached                                          Checklist completed by:
Delivery address correct