Dinkum Hire Form – Bradley Hain

Time & Date
Date of Service*
DD slash MM slash YYYY
Time of Service*

: HH

MM
Customer Details
Customer Business Name
Customer Business Contact Person
Customer Address
Street Address City/Suburb State / Province / Region Postcode Country
Customer Phone Number
Customer Email Address
Project Details
Project Business Name
Project Business Contact Person
Project Address*
Street Address City/Suburb State / Province / Region Postcode Country
Project Phone Number
Project Email Address
Other Details
Job to be Charged to*
Service Type*
If other, please specify (Service Type)
Duration of Hire*
If other, please specify (Hire Duration)
Panel Type
- 2.5M Standard
- 2.5M HD
- 3.5M Standard
- 1.5M Standard
2.5M Standard Quantity & Other Details
2.5M HD Quantity & Other Details
3.5M Standard Quantity & Other Details
1.5M Standard Quantity & Other Details
Blocks Type
- 32mm Concrete Blowmold
- 40mm Concrete Blowmold
- 40mm Concrete Raw
- 32mm Half-thickness Swimming Pool
32mm Concrete Blowmold Quantity & Other Details
40mm Concrete Blowmold Quantity & Other Details
40mm Concrete Raw Quantity & Other Details
32mm Half-thickness Swimming Pool Quantity & Other Details
Clips
Metal Clips Quantity & Other Details
Back Supports
Back Support Quantity
Back Support Counterweights
Shade Cloth Quantity (Metres)
Additional Notes
Delivered By*
Received in Good Order & Condition By*
Signature*
Email to be sent to*
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Time & Date