Neil McLean Automotives - Parts Order Form

We will dispatch your parts within twenty four hours within receiving payment (if in stock or previously ordered and stocked) or you pay no freight.

To pay by credit card please enter your details below and fax it to us, do not e-mail your credit card deatils as the system is not secure. Alternatively, you may wish to pay by bank cheque or electronic funds transfer. If you wish to pay by electronic funds transfer please contact us for account details. We accept Visa and MasterCard.

Please Print, fill out and fax/mail this form to us. Details are below.

Make: ____________________________________________________________________________________

Model: ____________________________________________________________________________________

Year: ________________

Chassis No: _______________________________

Part Description: _____________________________________________________________________________

____________________________________________________________________________________________

Part No: ________________________

Your Name: _____________________________________________

Contact No: _____________________________________

Fax No: __________________________________

Shipping Address:_______________________________________________________________________________

______________________________________________________________________Post Code:_______________

Credit Card Details

Credit Card No: ________ ________ ________ ________

Expiry Date: ____/____

Name on Card: ________________________________________

Our fax No: +618 9250 1404

Our mailing address: Neil McLean Automotives
15 Elliott Street
MIDVALE Western Australia 6056