Schedule Request Form

	Club Demonstration Services Inc., Australia
PHONE: 011-61 2 8753 7900 / FAX: 011-61 2 8753 7999 / HOURS: 8:30am to 5pm Monday through Friday

Scheduling Request Form

Requests should be made at least two weeks prior to the requested date(s). Note: This lead time does not guarantee spaces available for your requested dates. You will receive an email/fax confirming your demo requests. If you do not receive a confirmation within 72 hours, contact the Scheduling Department immediately. Please review your confirmation carefully.

* indicates a required field

Billing Contact Information:

Scheduling/Broker Information:

(If different from Billing Contact Information)

* Vendor Name:
* Australia Business No:
Phone:
Fax:
* Person Placing Order:
* E-mail:
PO#:

Company Name:
Phone:
Fax:
E-mail:

Demo Type Information

Request Type:

Schedule

Cancel

Change

REASON FOR CHANGE OR CANCELLATION:

(all changes must have an explanation so it can be communicated to your buyer)

Type of Demo: Regular Combo Split (select one)

* Split Vendor Program

Are you interested in the Split Vendor Program?

Yes No (By selecting Yes, your Name, Item Description, Item Number, Phone Number and Email Address will be added to our Master Split Vendor List).

* Date(s) you wish your product scheduled/canceled

* What is the number of demos dates you would like to schedule in each location?:

Product Information
* Product Name:		* Costco Item #:
Product Name:		Costco Item #:

Select the stores where you want demos scheduled/changed

Select Store(s) for this Demo: Check/Un-Check All Stores:

# of Stores Selected:

5101 Docklands, Melbourne

5102 Auburn, Sydney

5103 Canberra, Canberra

* Demo Instructions

Split Demo Information If this is a SPLIT DEMO, and you ALREADY have a split partner, complete the following:
Split Partner:		Phone:
Rep. Name:		FAX:

Product Name:		Costco Item #:
Substitute Product Name:		Costco Item #:
* Can the product run alone at the full labor rate? Yes No

Instructions for a Split Demonstration

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PHONE: 011-61 2 8753 7900 / FAX: 011-61 2 8753 7999 / HOURS: 8:30am to 5pm Monday through Friday

Scheduling Request Form

* Split Vendor Program

Split Demo Information

Instructions for a Split Demonstration