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	A.W.R. Smith Process Instrumentation cc
	tel: 011 782 7279 or 011 888 7144 fax: 086 648 7664 e-mail: sales@instruments.co.za
	PO Box 449 Pinegowrie 2123 - Gauteng - South Africa

Order Form (for SA residents only)

If you know what you want then please complete the form below to expedite your order

To check prices click here to view our current price list

If you only need a quote or more information then please click here

*Company Information are required fields**
Company Name: *
PO Box: *

Postal Code: *
VAT Number: *
Order Number: (if required)

Where must we send the invoice for payment * are required fields
Contact Name: *
Telephone Number: *
Fax Number: *
E-mail Address:

Where must we deliver your order * are required fields
* There will be a R75 (excl VAT) delivery charge to any SA destination (max 5kg)
Delivery Method: *	Deliver Collecting Your courier to collect
Contact Name: *
Telephone Number: *
Delivery Address: *


If your courier collecting:	Courier Name Account No

What would you like to order
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