BUSINESS PAYMENT FORM

Business Order Form

Business Information
Company Name
Business Name
Personal Name	*
Physical Address 1	*
Physical Address 2
Postal Address 1	*
Postal Address 2
City	*
Postal Code
State / County / Province	*
Country	*
Website
Email Address	*
Phone	*
Fax
Authorizing Person's Name	*
Mobile Phone
Product and Shipping Information
Product Ordered	*
Quantity Ordered	*
Item Value (if known)
Value of order (if known)
Prefered Method of Shipping (choose One)		Air Freight Sea Freight Other (please specify below in further information)
Freight Cost (if known)
Any Further Information
Payment Methods
Payment Method (choose One)	*	Bank Transfer (T/T) L/C Cheque
by Bank Transfer
to The ANZ National Bank of New Zealand, Hamilton, New Zealand account Hi Image Enterprises Limited # 06-0583-0460454-00 . Swift No. NBNZNZ22 Please fill in details in payee particulars, code and reference - thank you.
by Cheque
by CHEQUE (check) written and posted to : Hi Image Enterprises Limited, PO Box 2380, Queenstown, 9349, New Zealand (Note : clearance takes 20days minimum. For 5 day NZ cheque special clearance add NZ$25.00)