NDIS - Plan Managed Customers
Please fill in form below and submit. Once we receive your details, we will email you an invoice to forward on to your NDIS plan partner. If purchasing socks for more than one person, please complete a separate form for each individual. If you have any difficulty completing this form or require any assistance, you can email us at: hello@dotonasock.com.au or phone: 0427 239 123
Your Full Name
*
First Name and Last Name
Email
*
Phone Number
*
NDIS Participants Full Name
*
NDIS Number
*
Plan / Program Manager
*
Plan / Program Manager contact details (please include at least 1)
phone number
email
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please select your sock size (dot colour)
*
Please Select
Yellow dot (US kids 6-8)
Purple dot (US kids 9-12)
Red dot (US Youth 12 - 2)
Green dot (US Youth 2-4 / Womens 3-6)
Orange dot (US Mens 5-7 / Womens 7-9)
Aqua dot (US Mens 7-10 / Womens 9-12)
Please select the sock style & pack sizes that you would like to order
prev
next
( X )
White Quarter Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
Item subtotal:
$
0.00
AUD
Black Quarter Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
Navy Quarter Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
Grey Quarter Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
White Ankle Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
Black Ankle Socks
Please select pack size
$
60.00
AUD
Pack Size
Starter Pack (10 pairs)
Refill Pack (5 pairs)
Sample (single pair)
Submit
Should be Empty: