Mobility Scooter Carry Bag Order Form

Mobility Scooter Carry Bag Order Form
Roland Priestley Mobility Centre

www.rolandpriestley.com.au
Please select item box and then quantity
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Mobility Scooter Rear Carry Bag VA-134ST$50.00 AUD

Quantity
Item subtotal:$0.00 AUD

Aidapt Deluxe Lined Scooter Crutch bag VA134SS$70.00 AUD

Quantity

Aidapt Scooter Pannier Bag VA137st$49.00 AUD

Quantity

Subtotal $0.00 AUDShipping $0.00 AUDTotal $0.00 AUD
Address

Street Address

Street Address Line 2

City/Suburb/TownState

Postcode
Valid Australian Phone Number

Area CodePhone Number
Shipping & Packaging. These items come in a cardboard carton. To enable to keep the shipping cost low these items will be sent without the carton as the carton does not fit in the satchel. (Except the Pannier bag which is slightly smaller and the carton will fit in the Satchel)

When you click Submit, you will be taken though to Paypal where you can pay with your credit or debit card or Paypal account. You do not need to belong to Paypal to pay by card.
Optional delivery Instructions if no one is home
(Example: Leave at front door if no one is at home)
Should be Empty:

Roland Priestley Mobility Centre