Online Battery Order Form - All orders are confirmed via telephone. Information boxes marked with an asterisk (*) require an answer.
Purchase Order#:
Date Needed:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Battery Model or Part#:
*
Forklift Make / Model:
*
Plug Color:
*
Quoted Price:
*
Taxable?:
*
Yes
No
Tax Exemption# (if applicable):
Would you like to set up a N30 account? If so, please fax credit references to: 646-519-4723, Attn: Credit Dept.:
Yes
No
BILLING - Company Name:
*
BILLING - Complete Address:
*
BILLING - Contact Name:
*
E-Mail Address:
*
BILLING - Phone#:
*
Is the shipping information the same as the billing information? If not, please add the desired shipping information below:
*
Yes
No
SHIPPING - Company Name:
SHIPPING - Full Address:
SHIPPING - Contact Name:
SHIPPING - Phone#:
CREDIT CARD INFORMATION - If you would like to make this purchase using a credit card, please enter the type of card (Visa, MaterCard, Amex):
Card#:
Expiration Date:
Authorization Code:
Card Holder:
If you have any questions, please call our web sales dept. at: 877-4GB-Battery (877-442-2288)
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GB - Home
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How to Order
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Request Quote - BATTERY
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Request Quote - CHARGER
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|Order Form - BATTERY|
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Battery Sizes and Specs.
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Credit Application - Online
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Credit Application - Printable
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Warranty Registration
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Instructions - Online Forms
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Suggestions
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