Ordering Page

Ordering from Jacobs Electronics

An complete on-line ordering and secure payment system should be available in the near future.   In the meantime, please lodge your orders by completing and submitting the form below.  It is important to include the part number, name or description and quantity of each item you require.  These details may be obtained from the price lists accessed via our products pages (follow the links at the end of each detailed product description page).  If ordering more than five different items, please submit each five items as a separate order.

In the interests of security, please do not quote credit card details on the order form.   We will contact you to resolve payment and delivery details.

Jacobs Electronics Order Form
(Fields marked with an asterisk are compulsory)
CONTACT DETAILS
  Name: *
  Street Address: *
  Suburb: *
  State:
  Postcode: *
  Country:
  Telephone: *
  Fax:
  Email Address:
ITEMS ORDERED
 FIRST ITEM:
   Quantity: *
   Part No: *
   Name or
   Description: 		*
 SECOND ITEM:
   Quantity:
   Part No:
   Name or
   Description:
 THIRD ITEM:
   Quantity:
   Part No:
   Name or
   Description:
 FOURTH ITEM:
   Quantity:
   Part No:
   Name or
   Description:
 FIFTH ITEM:
   Quantity:
   Part No:
   Name or
   Description:
  Additional
  Information:
Privacy Statement
By submitting this form, you authorise us to use the information provided for the internal purposes of this company and our related distribution companies. In all other respects, except as necessary for delivery and for collection of payment, we warrant that your details will not be sold or passed on by us to any third party, whether for use in mailing lists or for any other purpose.
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