EarplugsOnline Order Form

Go here for Fax/phone/email orders

Payment Options:

	Direct Deposit (Preferred method) Our Bank details will be EMAILED to you.
	Credit Card (Local or International Orders)
	Customers in the USA please click here

Personal Details: (Please use your POSTAL address)

First Name			Last Name
Street1			Street2
Town			Province
Country			Postal Code

Email Address
Confirm Email Address
Phone Number
Comments/Special Instructions

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Product Details:

		EARPLUGS single pair
		Mighty Earplugs SINGLE pair in carry case. The Worlds best all natural, highest noise blocking earplugs. NRR34.
		Price: R 49.00
		Quantity = R

		EARPLUGS Two Pairs
		Mighty Earplugs TWO pairs in carry case. The Worlds best all natural, highest noise blocking earplugs. NRR34.
		Price: R 98.00
		Quantity = R

		EARPLUGS Six Pairs **SPECIAL OFFER
		Mighty Earplugs SIX pairs in carry case. The Worlds best all natural, highest noise blocking earplugs. NRR34
		Price: R 240.00
		Quantity = R

		EarSoft Neon Earplugs
		Yellow foam earplugs 200 per box indiviually wrapped. Highest Protection, ultimate comfort. NRR 33dB. Self adjusting foam provides low pressure seal.
		Price: R 900.00 (R4.50 ea)
		Quantity = R

		EarSoft Neon Earplugs with cords
		Yellow foam earplugs with cords 200 per box indiviually wrapped. Highest Protection, ultimate comfort. NRR 33dB. Self adjusting foam provides low pressure seal.
		Price: R 1,100.00 (R5.50 ea)
		Quantity = R

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Postage and Packaging:

	Normal mail South Africa Price R 18.00 (no delivery guarantee)
	Fast mail South Africa Price R 20.00 (no delivery guarantee)
	Registered Mail R 22.00 (Please use this for tracking number)
	Overnight Courier R 60.00 (Post office to post office counter)
	Overnight Courier R 120.00 (DOOR to DOOR)

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Grand Total (Including Postage & Packaging)

Verification

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You will be sent to a page with our bank details AND you will also be emailed a copy of your order and our bank details so you can make your deposit.