Wamuran FruitGrowers Co-op Orders

D'Aguilar Highway, Wamuran Queensland 5012 Australia
Phone: (07) 5496 6500 Fax: (07) 5496 6217
Email: shop@wamuranco-op.com.au

ONLINE ORDER FORM

CUSTOMER INFORMATION

Name
Trading as		ABN No.
Address
City	State Postcode
Email Address		Co-op Shareholder
Phone Number		Account Customer

METHOD OF PAYMENT

My credit card details: Card Number Expiry Date

DELIVERY INSTRUCTIONS

Order will be collected from the Co-op on Date

Please despatch the order to this address
(A freight charge will apply)

Please deliver the order to this address
(Orders can be delivered to addresses within 20 km of the Co-op. A delivery fee will be charged.)

Special delivery instructions

ORDER DETAILS

QUANTITY SIZE TYPE ITEM DESCRIPTION

5 20 kg Bags Meaty Bites - Mince & vegetable (Sample only)

Order will be collected from the Co-op on	Date
*Please despatch* the order to this address** (A freight charge will apply)
*Please deliver* the order to this address** (Orders can be delivered to addresses within 20 km of the Co-op. A delivery fee will be charged.)
Special delivery instructions

QUANTITY	SIZE	TYPE	ITEM DESCRIPTION
5	20 kg	Bags	Meaty Bites - Mince & vegetable (Sample only)