Weber & Weber - higiena dla medycyny

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To improve the organisation of our Sales Department, with special emphasis on the customer, we prepared a simple form for ordering our products, available in two versions:

downloadable PDF document for viewing and printing using Acrobat Reader. Upon completion, it may be sent by fax at + 48 33 852 92 00
electronic version automatically generated and sent to our mailbox.

Upon receipt of your form, a Sales Department employee will contact you to confirm the order and to complete the delivery as soon as possible.

order form - MEDICINE

product name	package box/roll	product code	no. of pieces	no. of rolls or boxes in external package	number of ext. pack. green colour	number of ext. pack. blue colour	number of ext. pack. yellow colour	number of ext. pack. apricot colour	number of ext. pack. heather colour	number of ext. pack. pink colour	number of ext. pack. white colour
Sheets width 33 cm	roll	M33N-50-kolor	50	12 rolls
Sheets width 33 cm	folded into rectangle in a box	M33K-48-kolor	80	6 boxes
Sheets width 51 cm	folded roll	M51S-50-kolor	40	9 rolls
		M51S-80-kolor	25	9 rolls
		M51S-160-kolor	12	9 rolls
	behind the bed roll	M51N-50-kolor	80	6 rolls
		M51N-80-kolor	50	6 rolls
		M51N-160-kolor	25	6 rolls
		M51N-40M-kolor		6 rolls
Sheets width 38 cm	behind the bed roll	M38N-50-kolor	80	8 rolls

Please specify the ordered numbers of external packages of a given product in the empty fields..

Customer information
(i.e. VAT invoice data)

Delivery address
(leave empty fields where the data is identical to the customer information)

First and last name
of contact person

Company name

Company address

Contact telephone

NIP (Tax ID number)

Notes

Contact telephone

Fax

E-mail

I declare that I am a VAT payer and please send an invoice without signature.

Form of payment:	bank transfer prepayment postal collection orde

Form of transport: shipment by GLS forwarding company. Time of delivery for standard orders is up to 7 days.

I authorise the collection and processing of my personal information (pursuant to the Personal Information Protection Law of 29.08.1997) in Weber & Weber Sp. z o.o. database. I shall have the right to review my information, to correct or delete it.
The information will only be used for marketing purposes. It is given voluntarily.

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