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Sales Enquiry

Sales Enquiry Form

A form needs to be completed for our records for all enquires for sales.

You may fill in this form now to get you thinking, it will not be set in concrete, and is only used as the final agreement when you are satisfied and have received an invoice.
If in doubt or you have questions, write a note in the message section or you may phone prior to filling in this form.
You may make as many phone calls as you wish. You will not offend.

Items with the * are required to be filled - if you have no idea, put an "x". If you hope to collect from our base, put "Base".

You will be contacted either by email or phone to receive the information you may require or to complete the agreement or receive the relevant invoice by email.

Note: You will receive a copy of this form by email for you records.

Thank you.

Payment and Credit Card Policies

GST (Goods and Services Taxes)
All mobility devices, sales, service, parts and hire is GST exempt and GST is not charged on invoices.

Sales Contracts

Please fill in the form below, following phone discussion if required.
You will be provided an invoice by email, or at the time of delivery / collection.
You may elect to pay by Cash, Bank Transfer or Debit / Credit Card.
Cash on delivery to your home / business or at pickup from our base is acceptable.

Mobility Scooters for Hire accepts Visa and MasterCard and is able to process MOTO (mail order / telephone order).
Payment by Credit Card is through our CBA EFTPOS portal to Ronica Trade ™, and is transacted at delivery time.

Data Protection

By entering into a sales agreement you agree that we can process and store your personal information in connection with this agreement. We will use your information to provide services to you as best as possible, analyse statistics, for market research, credit control and to protect our assets.

You agree that if you break the terms of this agreement we can pass your personal information to credit-reference agencies, debt collectors, the police or any other relevant organisation.

Your personal information is held securely and in strict confidence by Mobility Scooters for Hire, and is not given to any other party excepting as required by law.


Date :   
Your Name (common & family) : *
Home Address No. / Street : *
Home Address Suburb / City : *
Home Address State / Postcode : *
Phone Number : *
Email Address : *
Preferred method of payment : *
How did you find us ? : *
   Your message : Please give a detailed idea of the device you require. *

I confirm I am a human.  *  

* Required

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Open Hours
Mon Tue
Thu Fri
Saturday /
2 - 9 PM
9 - 9 PM
9 - 9 PM
9 - 6 PM
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2 Wellman Street, Reservoir, VIC 3073








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