Order

You can place a secure online order using the form below.

We currently service the following areas in Western Australia:

On completion of this order, your 12 month rental agreement with Waterchoice will commence. In your second month you will receive 2 weeks for free.

Contact Details

First Name

Surname

Company Name (if applicable)

ABN (if applicable)

Contact Telephone Number

Address

Installation Address

Bench Top System

Qty @ $ 65.00 ea
(first month rental)

Floor Standing System

Qty @ $ 65.00 ea
(first month rental)

How Did You Hear About Us?

Comments

Total Amount
not calculated yet

Payment Method

Note: Accepted cards are Visa and Mastercard

Credit Cardholder Name

Credit Card Number

Credit Card CVV

Credit Card Expiry (mm/yyyy)

I have read, understood and agree to the terms and conditions.

Security Question
What is 3 + 6?