ORDER FORM
Wild Bean Coffee Cards Customer Details Name
Order No.
UBT Customer Code
Date
Address Suburb/City Postal Address Suburb/City
Postcode
Phone
Fax
Campus
Local CBM
Email
Locality
For more information phone the UBT Helpdesk on 0800 66 33 62 If you haven’t received confirmation of your order within 5 working days, please contact the Helpdesk.
Your Order 100 PACK WILD BEAN COFFEE CARDS
Qty
x $440.00
=
$ 0.00
20 PACK WILD BEAN COFFEE CARDS
Qty
x $88.00
=
$ 0.00
Freight
=
FREE
TOTAL
=
Prices include GST
$ 0.00
Payment Details Online
Onefocus NZ Trust Bank Account No: 06-0317-0801893-01 (must include your name and customer code in the references)
Cheque
Payment must be mailed along with a copy of the Order Form to: Onefocus NZ Trust, PO Box 769, New Plymouth 4340
Name
Date
Signature
Please email form to
[email protected]
SUBMIT FORM
PHONE 0800 UBT 123
EMAIL
[email protected]
WEB www.ubteam.co.nz
