Building Better Communities with Rotary Order Form
Business Delivery Information
Business Name |
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Delivery Address |
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Postal Address |
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Email Address |
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Order Details
Counter Top Units (CTU) | 16 pieces |
Number of CTUs ordered | _____ CTUs |
Number of air fresheners ordered | _____ CTUs x 16 =_____air fresheners |
Order Reference |
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Is this to become a monthly standing order for a minimum of 12 months? | YES |
I understand that this order will be repeated each month until the Rotary Club is given three months’ notice by email of any reductions to this standing order. | |
Agreement
I __________________________________________________________ (full name) declare:
I am an authorised signatory of the Business and have authority to enter into this agreement on behalf of the Business. Invoices will be emailed after order despatch.
Signature
Signature |
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Name |
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Title |
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Date |
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Please complete this form and return it to your Club President’s email address | |