The online order form

Please fill in this form and then press the SEND button at the bottom. Please note: this form requires Internet Explorer version 4 or higher. If you have an older or incompatible browser, please print out the printable order form instead and fax it to to, please.

For assistance, please don't hesitate to call us on +49-7121-38113-40 or info@e-ternals.com. We can also fax, post, or e-mail you the form!

If you prefer a printable order form which you can fax or post, please click here.

Please note:

This is not a definite order yet, just a form that helps us to create one for you.

Based on the type of shipping that you choose in this form, we will calculate the exact costs and then send you a proper order form for confirmation.
 
 

Your name:

Your phone number:

Your e-mail address:

 

Billing address:

Name:

Street:

City:

Postal code (ZIP code):

State:

Country:

 

Delivery address:

Name:

Street:

City:

Postal code (ZIP code):

State:

Country:

 

Your order no.:

 

Product ID

Description

Quantity

Unit price

Extension

 

Shipping options:   

 

Sales tax:   

Our EU-VAT ID no. is:   

 

           

 

When we receive this form from you, we create an order number for you and produce an order form which includes your selected shipping costs, the sales tax (if applicable) and the total. We then send you that form with the request to confirm the order.

If you prefer to use the printable order form instead, please click here.