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Reseller Supplies Order Form

Supplies can only be ordered by an authorised manager.

Supplier Details

 4Business Name:    

 4Mail Address: 



 4Ordered by:    

 Loyalty Cards Program

 4Customised cards required: Qty   

 4Collect stamps card: Qty

 4Customised Supplier DL information brochure: Qty

 4Customised Posters:    B5 ,     A4 ,     A3 ,     A2


 General Point of Sale Material

 4Window decal:    Small decal Qty   ,   Large decal Qty    

 4Wobbler:  Qty  (9cm x 11cm) with double sided tape   or magnet 

 4Deal Card:   Qty    with double sided tape   or magnet 

 4Counter stand signs:    Small DL (10x14cm) size ,    Small B5 (14x21cm) size  

 4Posters:    B5 ,     A4 ,     A3 ,     A2

 4Local Benefits Directory:  Qty

 4Information / application brochure:  Qty

 4Brochure holder for Information / application brochures:  Qty

 4Employee memberships:   Qty 




    We will mail the above order within 10 working days of your order. Please confirm the above order with the

    Supplier managers name below.

    Name:     Telephone: