HomeAboutGalleryContactBookingQuote BOOKING REQUEST Name * Surname * Contact Number * E Mail * Unit Details Vehicle Type Motorcycle Trike Quad-bike ATV Golf Cart Jet-ski Boat Other Make & Model * Panniers? (if applicable) Yes No Approximate Value of Unit * If you have more than one Unit to transport please submit individual requests Transport from Company / Individual? Company Individual Name and Surname Company Name (if applicable) Collection Address City Collection Address is? Residential House Residential Estate Complex Business Telephone Cell Number Transport to Company / Individual? Company Individual Name and Surname Company Name (if applicable) Delivery Address Delivery City Delivery Address is? Residential House Residential Estate Complex Business Telephone Cell Number Billing Information Who do we bill? Sender Receiver Other Billing Details * Same as Above Different, let me enter my own Additional Information Date ready for collection Date requested for delivery (Note that it may not be possible to guarantee delivery on a specific date – however, Rothwinds Innovations CC will endeavor to accommodate delivery dates as far as possible) Special Requests / Additional Comments I have read and accept Rothwinds Innovations CC’s Terms & Conditions * Yes No I am a Human Cell: (+27) 83 715 6388 – Tel: (+27) 31 767 1455 – Email: info@rothwinds.co.za © Rothwinds Innovations – 2017 Terms & Conditions Website Design by SDDS Web Design
