http://www.dclabs.com.au
 

Please order online here,  or go to printable order form and fax it to 03 9807 8600

Title in equipment remains with DCLABS Pty Ltd until payment is received in full.

Cheques may be made out to "DCLABS Pty Ltd"  PO Box 1018, Ashwood, VIC, 3147.

Bank deposits may be made under arrangement with Sharon Crow - 03 9807 8600

*Mandatory Fields

Step 1 - About your Organisation
Organisation*:
Trading Name*: i.e. DCLABS Pty Ltd
Short Name: i.e. DCLABS
ACN:
ABN:
Billing Address
Address*: 
City*:  State:    Postcode*
Country*:
Contact   First : Last:
Email :  
Phone*:     Fax:
Mobile :

Step 2 -  DCSERVER Site Location

Address*: 
City*:  State:    Postcode*
Country*:
Contact   First : Last:
Email :  
Phone*:     Fax:
Dedicated Phone Number that DCSERVER would use (If Known):   

Step 3 -  Reseller (If Applicable)
Reseller ID :

Step 4 -  IT Support (If Applicable)
Do you have existing IT support?  If Not, then skip IT Support section
Contact : First : Last:
Organisation :  (If Applicable)  
Phone:   Fax:
Mobile:
Email 

Step 5 -  Prefered Internet Domain name (i.e. www.CROWTECH.com.au) 
I already have a domain name that I wish to re-delegate to the DCSERVER which is   otherwise I wish to select a new domain name:
First Choice:  www.  
Second Choice: www.  

Step 6 - Equipment
Please total and or select  the equipment  you wish to purchase.

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Qty Equipment