Advocacy Service Providers Order Form - Nationwide Health and Disability Advocacy Service

Freephone 0800 555 050 - 8.30am to 6pm, Monday to Friday

NZSL Translations Available Here

Advocacy Service Providers Order Form

Providers - Please complete the Order Form below, a Tax Invoice will then be sent with payment instructions.

Please note that orders will not be dispatched until payment has been made in full.

All prices include GST and delivery.

Your Name*

Your Email*

Contact Telephone*

Company Name*

Order Number

DELIVERY DETAILS

Delivery Address*

Suburb*

City*

Postcode*

Special Delivery Instructions

Contact Name*

INVOICE DETAILS (if different from above)

Company Name

Contact Telephone

DELIVERY DETAILS (if different from above)

Alternative Delivery Address

Suburb

City

Postcode

RESOURCE OPTIONS

Advocacy Leaflet - English

50 - $12.50100 - $25.00150 - $37.50200 - $50.00Other

Please enter the leaflet quantity in multiples of 50:

Advocacy Leaflet - Te Reo

50 - $12.50100 - $25.00150 - $37.50200 - $50.00Other

Please enter the leaflet quantity in multiples of 50:

Bookmark

50 - $13.00100 - $26.00150 - $39.00200 - $52.00

Magnifying Card (business card size) - CURRENTLY OUT OF STOCK, AWAITING SUPPLY

50 - $15.00100 - $30.00150 - $45.00200 - $60.00

Pen

50 - $50.00100 - $100.00

Advocacy Pocket Card

50 - $8.00100 - $16.00150 - $24.00200 - $32.00

Shopping Tote Bag

10 - $30.0020 - $60.00

Stress Ball - CURRENTLY OUT OF STOCK, AWAITING SUPPLY

10 - $30.0020 - $60.00

Advocacy Posters

EnglishMāoriSamoanArabicSimplified ChineseTraditional ChineseSomali

Please enter the poster size and amount required:

Remember, we are here to help.

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