Customer Details *Name: *Street Address Cross Street *Suburb *Postcode *Preferred Phone No Please select... Mobile Home Work *# Alternate Contact No: Please select... Mobile Home Work # Alternate Contact No 2: Please select... Mobile Home Work # *Email *Confirmation Email SMS to Mobile Call Me Our call centre will confirm your service date. Please tick how you would like to be notified. Appliance Details *Brand Details *Type of Appliance Air Conditioner B.B.Q Ceiling Fan Cookware Dishwasher Dryer (must be on floor) Freezer Fridge Microwave Rangehood Washing Machine Wine Cooler Model *Fault *Type of Warranty Manufacturer’s Warranty Out of Warranty *Conditions and Service Rates Proof of Purchase MUST either be received by our office 24hrs prior to the day of service or presented to the Technician on the day of service. If Proof of Purchase is not provided as above the Technician MUST be paid on the day of service. Our rates are $110 Service Call, $110 p/hr Pro-rata + parts. If no fault is found or fault is due to miss-use, neglect or incorrect installation the warranty will be deemed void and the Technician MUST be paid on the day of service. Our rates are as above. We accept Cash, Cheque, Eftpos, Mastercard and Visa. Please check this box to confirm you understand and accept the above Conditions and Service Rates. *Conditions and Service Rates Our rates are $143 inc GST Call Out (includes the 1st 15 Mins). $33 inc GST for every 15 Mins (or part there of) + Parts. Payment MUST be made on the day of Service. We accept Cash, Eftpos, Mastercard, VISA or Cheque. Please check this box to confirm you understand and accept the above Conditions and Service Rates. Date of Purchase Purchased From Serial No *Preferred Day of Service *Service Call Time Frame Notification We will send a text message to your mobile phone before 7.30am on your day of service with a time frame of the job. If the time frame provided does not suit please call our Service Dept on 3137 3633 after 8am to arrange an alternate day. To arrange for the Technician to phone 1/2 hour prior to arrival please call our Service Dept on (07) 3137 3633. This MUST be arranged prior to the day of the Service Call. Please check this box to confirm you understand and accept the above Time Frame procedures.