Online Ordering

Required information is in bold

Your Details
First Name:		Last Name:
Contact Number:
Email:
Company Name:
Adelaide Fuel Distributors Representative’s Name:
Purchase Order No:
Existing Customer Account Number:
Delivery
	I’ll Pick it upPost it to me
Attention to:
Postal Address:
Suburb/City:		State:
Postcode:
Billing
As Above:
Attention to:
Postal Address:
Suburb/City:		State:
Postcode:
Your Cards
Value of Card:	Number of Cards:	Total Value:
$25
$50
$100
$500
$1000
		Total $

Payment
Payment options	Credit Card/Direct Deposit Upon submitting your order, one of our customer service representative will contact you by phone to arrange payment. Cheque/Money Order Please make cheque payable to "Adelaide Fuel Distributors" Confirm your order, print it out, sign the printout and post, or fax it together with your payment to: Adelaide Fuel Distributors PO Box 333 Enfield Plaza SA 5085 Fax: 8349 8578