New Product Order Form

DELIVERY DELAY NOTICE: There will be limited shipping of perishables (e.g. Vespex) this week due to Monday 2nd February being Nelson Anniversary and Friday being Waitangi Day. We will send to urban addresses on Tuesday 3rd February, but all other shipments are delayed until Monday 9th February. Apologies for the inconvenience.

Name*

First Name(s)Last Name

E-mail*

Contact Number*

PrefixPhone Number

Organisation (if any)

Billing Address*

Address

Address Line 2

CityState / Province

Postal / Zip CodeCountry

IMPORTANT DELIVERY INFORMATION: Courier and packaging charges apply to all deliveries, but you can arrange your own pick-up from our office in Stoke, Nelson. We cannot deliver Vespex to PO Box addresses. If rural North Island, we strongly recommend providing a non-rural shipping address below (e.g. a business that will receive it on your behalf, or a friend/relative in town), or opt to be provided the details of your nearest courier agent.

We do not allow delivery or pick-ups prior to payment being received, unless you have a credit account set-up with us in advance.

Delivery Options*

I will arrange pick-up from NelsonCourier to my shipping address belowSend me detail of nearest courier agent

Shipping Address (if different from billing address)

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Any additional delivery instructions

Colour	Quantity
Yellow
Green

Color	Quantity
Yellow
Green

Color	Quantity
Yellow
Green

Size	Quantity
S
M (OUT OF STOCK)
L
XL