Contact
Information
Title
Mr
Mrs
Miss
Ms
Other
First Name*
Last Name*
Company Name*
Position
Address
Suburb
City
State
Postal Code
Country*
Phone Number*
Fax
Number
Email*
Freight/Shipping
Information
Type of Goods or Commodity*
Estimated
Lbs
Kgs
Estimated
cubic
metres
cubic feet
From
City*
From
Country*
To
City*
To
Country*
Freight Type*
air
freight
sea
freight
both
Hazardous cargo*
not
hazardous
hazardous
Payment*
freight will be prepaid
freight
will be collect
Other
charges*
will be to the account
of Shipper
will be to the account of
Consignee
Insurance*
yes
no
If yes,
what amount?
Special instructions or requirements
