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Customer Service:Batteries Order Form


Your name:

Email Address:

Telephone Number

Mobile

Address to send batteries
<br/> <br/></td> </tr> <tr> <td class="style3" colspan="2">Type of Battery <br/> <br/></td> </tr> <tr> <td valign="top" class="style2"><img src="images/ba1.jpg"/> <select id="Quantaties - 3.6 Volt Saft Battery" size="1" name="Quantaties - 3.6 Volt Saft Battery"> <option selected="" value="0">0</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> </select> </td> <td valign="top" class="style2"><img src="images/ba2.jpg"/> <select id="Quantaties - 3.0 Volt 1/3N" size="1" name="Quantaties - 3.0 Volt 1/3N"> <option selected="" value="0">0</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> </select></td> </tr> <tr> <td valign="top" class="style2"><p>3.6 volt SAFT battery <br/> for 3000, 1200, R8 receivers<br/> <strong>$17.95 each excl shipping </strong></p></td> <td valign="top" class="style2"><p>3.0 volt 1/3N <br/> for R6 and R7 receivers<br/> <strong>$15.95 each excl shipping</strong></p> <p><br/> </p></td> </tr> <tr> <td class="style3" colspan="2"><h2><br/> Payment Options <br/> <br/> </h2></td> </tr> <tr> <td class="style2" colspan="2"><label> <strong> <input type="radio" value="Credit Card" name="Payment Type"/> Credit Card</strong></label></td> </tr> <tr> <td class="style2" colspan="2"><label/> <table cellspacing="0" cellpadding="0" border="0"> <tbody><tr> <td class="style2"> </td> <td class="style2">Type of Card</td> <td><select id="Card Type" name="Card Type"> <option>Card Type</option> <option value="Visa Card">Visa Card</option> <option value="Master Card">Master Card</option> <option value="Bank Card">Bank Card</option> </select></td> </tr> <tr> <td class="style2"> </td> <td class="style2">Name on Card </td> <td><input type="text" size="40" id="CreditCard_Name" name="CreditCard_Name"/></td> </tr> <tr> <td class="style2"> </td> <td class="style2">Card Number </td> <td><input type="text" size="40" id="CreditCard_Number" name="CreditCard_Number"/></td> </tr> <tr> <td class="style2"> </td> <td class="style2">Expiry Date </td> <td><input type="text" size="6" id="CreditCard_Expiry" name="CreditCard_Expiry"/></td> </tr> </tbody></table></td> </tr> <tr> <td class="style3" colspan="2"><input type="radio" value="Direct Transfer" name="Payment Type"/> <strong>Direct Transfer to our bank </strong></td> </tr> <tr> <td class="style2" colspan="2"><table cellspacing="0" cellpadding="0" border="0"> <tbody><tr> <td class="style2"> </td> <td class="style2">Bank: Commonwealth Bank <br/> BSB: 064165 <br/> Account: 10359418 <br/> TITLE: The Hidden Fence Company </td> </tr> <tr> <td class="style2"> </td> <td class="style2">Please use your last name as your bank reference number </td> </tr> <tr> <td class="style2"> </td> <td class="style2"><input type="text" size="40" id="DirectTransfer_Reference" name="DirectTransfer_Reference"/></td> </tr> </tbody></table> </td> </tr> <tr> <td class="style3" colspan="2"><input type="radio" value="Cheque" name="Payment Type"/> <strong>Cheque</strong></td> </tr> <tr> <td class="style2" colspan="2"><table cellspacing="0" cellpadding="0" border="0"> <tbody><tr> <td class="style2"> </td> <td class="style2">Please contact me with the address of the nearest dealer for address to send cheque.</td> </tr> </tbody></table> </td> </tr> <tr> <td class="style2" colspan="2"> </td> </tr> <tr> <td class="style3" colspan="2">Comments / Further Information </td> </tr> <tr> <td class="style2" colspan="2"><table cellspacing="0" cellpadding="0" border="0"> <tbody><tr> <td class="style2"> </td> <td class="style2"><textarea id="Note" rows="6" cols="40" name="Note"/></td> </tr> </tbody></table> </td> </tr> <tr> <td class="style2" colspan="2"> </td> </tr> <tr> <td colspan="2"> <div align="center"> <input type="submit" value="Submit" name="Submit"/> </div></td></tr> <tr> <td colspan="2"> </td> </tr> </tbody></table> </form> <p> </p> <p> </p> <h2 style="margin-bottom: 0;"></h2> </div> <!-- InstanceEndEditable --><!-- InstanceBeginEditable name="rc" --> <div id="rc"> <img src="images/rc_dog9.jpg" alt="BigLeash Remote Trainer" name="rc_image" width="166" height="196" id="rc_image" /></div> <!-- InstanceEndEditable --> <div class="forceclear"></div> </div> <div id="tagline"><img src="images/logo_dog_2.gif" alt="It's all about your dog." name="tagline" width="324" height="57" id="tagline" /> <h6 class="white">1800 223 364 - Call Now to Order or speak to a Representative</h6></div> <div id="footer"> <div id="dogwatchlogo"><a href="http://www.hiddenfence.com.au/" target="_blank"><img src="images/hidden_fence_small_logo.gif" alt="Hidden Fence" name="logo_dogwatch" width="150" height="53" id="logo_dogwatch" /></a></div> <p><a href="about_bigleash.html">About BigLeash</a> \| <a href="purchase.php">Purchase</a> \| <a href="faq.html">FAQ</a> \| <a href="customer_service.html">Customer Service</a> \| <a href="bigleash_dealer.html">Become a BigLeash Dealer</a> \| <a href="contact_us.html">Contact Us</a><a href="#"></a> \| <a href="privacy_policy.html">Privacy Policy</a> \| <a href="site_map.html">Site Map</a> \| <a href="links.html">Links</a></p> <p>DogWatch® Hidden Fence brand® products are protected under U.S. Patent Nos.: 5,353,744; 5,465,687; 6,079,367; 6,467,435; 6,360,698.© 2009 DogWatch Inc. All rights reserved. Hidden Fence® All rights reserved.<br /> <br /> No photographs,illustrations or text can be reproduced in any form without the express written consent of DogWatch Inc.DogWatch Hidden Fences and Hdden Fence® brand should not be confused with Invisible Fence® or Invisible Fencing® which are products and registered trademarks of Invisible Fence, Inc. Remote Trainers, Remote dog training collars, Big Leash remote trainers should not be confused with Dogtra®, Innotek®, Sportdog®, and Petsafe® brands.</p> </div> </div> </div> <script type="text/javascript"> var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); </script> <script type="text/javascript"> try { var pageTracker = _gat._getTracker("UA-11811318-1"); pageTracker._trackPageview(); } catch(err) {}</script> </body> <!-- InstanceEnd --></html>