5th WHEELER ORDER / QUOTE FORM

Please fill out your requirements and send them off to us. Be sure to provide us with a contact email address or phone number.
We will then contact you with the price, and take your card details etc.

YOUR DETAILS:
Name

House Number & Road Name

Suburb / Town

State

Postcode

Email Address

Phone Number


YOUR 5th WHEELER DETAILS:
Make

Model

Measurements in mm:
1. Overall Length

2. Overall Width

3. Door position

4. See diagram

5. Width of door

6. See diagram

7. See diagram

8. Width

9. Body Length excluding goose neck

10. Gooseneck curve length


* It is essential that the measurements are accurate as possible. We recommend a soft tape measure is used or a piece of string (that can be measured afterwards)
Please phone Brian on 1300 304 332
for advice if required.


ACCESSORIES:

Please select the accessories that you require
Solar panel

Heat & Hail Defence

Hail & Heat defence Front
Hail & heat defence Rear


Please supply your prefered Payment method:






Select which samples you require:
Standard
Deluxe
Hail & Heat