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. Width of door

5. See diagram

6. See diagram

7. Body length

8. Distance from 5th wheel

9. Body Length excluding goose neck

8. 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
Gas bottle cover
1 set of single wheel covers
1 set of dual wheel covers
4X4 single wheel covers
4X4 dual wheel covers

Please supply your prefered Payment method:

Cheque
Credit Card
Visa Card
Bankcard
Mastercard