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ROAMfilter™ Plus Order Form
Thank you for joining us on our journey in ending rural thirst. Upon completion of this order form, you should receive an invoice for your order within 2-3 days.

*By completing this form, you consent to the collection and use of your personal information for the purpose of contacting you and sending you information by WateROAM Pte Ltd.

*Delivery will be by international shipping unless you can collect the system from our local Singapore office at I-cube Building, 21 Heng Mui Keng Terrace, S119613

First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Contact Number *
Your answer
Organisation
Your answer
No. of ROAMfilter™ Plus systems (US399 each) *
Your answer
Mode of payment *
Mode of delivery *
Delivery address
Your answer
VAT number (for international shipping, if applicable)
Your answer
When do you need the system? *
Your answer
Please fill in the name of your referral (if any)
Your answer
Remarks
Your answer
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