Order Form

1. Place your order with us below.

2. We will phone to confirm your order.

3. On invoice you can settle by clicking pay your bill above.

Credit CardsWe can now accept credit card payments via Protx logo

     
Contact Name:  
Company Name:  
Customer Address:  
Contact Number:  
Email Address:  
Order Reference No:  
     

Item 1

Cable Type:  
Connector Types:
Assembly Length:
Quantity:  
Colour of Cable:  
Booted:  
Special Pin Out:  
 
     

Item 2

Cable Type:  
Connector Types:
Assembly Length:
Quantity:  
Colour of Cable:  
Booted:  
Special Pin Out:  
 
     

Item 3

Cable Type:  
Connector Types:
Assembly Length:
Quantity:  
Colour of Cable:  
Booted:  
Special Pin Out:  
 
     

Item 4

Cable Type:  
Connector Types:
Assembly Length:
Quantity:  
Colour of Cable:  
Booted:  
Special Pin Out:  
 
     
Item 5
Cable Type:  
Connector Types:
Assembly Length:
Quantity:  
Colour of Cable:  
Booted:  
Special Pin Out:  
 
     
     
Date required:  
Delivered for the Attention of:  
Delivery Address, if different from above:  
     

 

Please review your order and the points below before submitting

 

Credit is available subject to status and may be withdrawn at any point.

Due to the nature of specialty custom cable assemblies we cannot accept returns or cancellations unless there has been an error on our part. 

Custom Cable Assemblies Ltd. cannot be held responsible for any error on the part of our customers, all ordered goods must be paid for.

All goods remain the property of Custom Cable Assemblies Ltd. until paid for in full.