5th WHEELER ORDER 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

* 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 3322 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