InjectorTech Service Order Form

Please read the shipping instructions carefully to avoid any problems.
Print the completed form and send it along with your injectors.

Your Shipping/Contact Details
Name:
Delivery Address:
Contact Phone Number:
e-Mail Address:
Bank Account for any Refunds:
Vehicle Details
Make:
Model:
Year:
Engine Model:
Mileage:
Type of Use (General, Performance, Fleet)
Injectors to be Serviced
  Number Each  
All MPI Injectors: $30.00  
GDI, TBI & Mono Point Injectors: $36.00  
Testing only: $15.00  
  Click to calculate  
Total, excl. GST:
GST Amount:
Total to Pay:
Your payment details:  
Print this Form    
If you cannot print this form then please click the submit button to e-mail it to us.
Make sure you include all the details above on a note included with your injectors.
If payment is made by internet banking please include the details with this form to avoid any delays.
Account for Payment: Injectortech  Account No: ANZ   010695 0056296 00
GST No 30 915 968