Please print this form and fax it to: + 91 - 44 - 24941425
Or mail / courier it to: 1, Sannadhi Street, Mylapore, Chennai 600004, India
Billing Address
Shipping Address(if different)
First Name
Last Name
First Name
Last Name
Address1
Address1
Address2
Address2
Address3
Address3
City
State
City
State
Country
Code
Country
Code
Phone
Fax
Email
Please enter your order below
Description (Please mention choice of colours, where applicable, against the code)
Quantity
Rate
Total Price
Code No.
Code No.
Code No.
Code No.
Code No.
Code No.
Code No.
Code No.
TOTAL
Special Instructions
Insurance & Duties You may leave this blank. We will calculate the insurance to be paid and inform you accordingly
For overseas customers, import duties may be applicable in your country.
Freight : To collect We will inform you of the amount to be paid for freight, prior to shipping.
Payment Terms
Please mail a demand draft (Bankers Cheque) for the total amount, payable at Chennai.
If you wish to pay by credit card, please photocopy your credit card on both sides, and fax it to us along with this form.
