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Bailey's Marine Fuels Website
Contact Us
1. Enter Details
2. Accept Terms and Conditions
3. Enter Direct Debit Authority
Completion
Step 1: Details
* required input
Step 2: Terms and Conditions
Step 3: Direct Debit Authority
* required input
Completed
Applicants Details
First Name *
Surname *
Address 1 *
Address 2
City *
State *
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode *
Postal Address to be the same as delivery address.
Address 1 *
Address 2
City *
State *
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode *
Driver's License No *
Date Of Birth (dd/mm/yyyy) *
Preferred Phone 1 *
Preferred Phone 2
Fax
Electronic Invoices
We email you your invoices within 24 hours of taking fuel so you can check your purchases before we take payment.
Email *
Email again *
Will this email address be where you wish electronic copies of your invoice to be sent?
Yes
No, then specify below
Preferred Email Address
for invoices
Boat Details
Boat Name
Registered No
Boat Make