ENQUIRY FORM

Name of Company
Contact Person
( Dr Mr Ms Mrs Mdm )
Designation
E-mail
Phone Number
Country Code: Area Code: Phone Number:
Fax
Country Code: Area Code: Fax Number:
Mobile
Country Code: Area Code: Fax Number:
Mailing Address
Nature Of Business
Subject
Purpose
Own Use Re-sell  
 
Please tick whichever is relevant:  
   
a) Empty First Aid Boxes b) Equipped First Aid Kits
c) Steel Commode Chairs d) Multi-Purpose Heavy Duty Plastic Chair
e) Plastic Garden / Pool Side Chairs f) Others
   
If (a) and/or (b) tick, please fill in below :  
   
Usage:  
Individual Gift / Premium
Offices / Shops Schools / Factories
Automobiles Others
 
Budget Quantity Required
   
Free Personalised Printing on Front Cover YES NO  
If "Yes" please indicate total number of colour(s)
 
Comment/Message
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