On-line order form

Mandatory fields *

Personal data

Name*: Jan
Surname*: Kowalski

Company data

Name: Kowadło
Taxpayer identification number: 121-121-11-22

Address

Street*: Kowalska
House number*: 11
Zip code*: 00-121
City*: Kutno

Contact

E-mail address*: jankowalski@gmail.com
Telephone number*: 600 121 121

Payment

bank transfer / COD (cash on delivery)


Products:

Product name*: Z-01
Amount*: 6
Type: left/right – hinges
Additional comments: Please do without holes.

To order more products please click on "+" and fill in required fields.:


4+6=?